PRIVATE BUSINESS

Transas Group Bill (By Order)

Order for Second Reading read.
	To be read a Second time on Wednesday 26 March.

Oral Answers to Questions

WALES

The Secretary of State was asked—

Drugs

Chris Bryant: What recent assessment he has made of measures to create effective local anti-drugs partnerships in Wales.

Don Touhig: Tackling the problem that drug misuse causes is an issue that is extremely important to me and to the Government. I am aware that the drug and alcohol action teams currently working in Wales will be integrated into the 22 Welsh community safety partnerships. We believe that that is a progressive way forward.

Chris Bryant: I am grateful to my hon. Friend for that answer. I am sure that he will be aware that it is no exaggeration to say that drugs are systematically undermining the social fabric of many valleys communities, especially former mining communities. I am sure that my hon. Friend will also agree that the answer to the problem must lie in establishing strong local partnerships between all the agencies involved. In my constituency, however, Rhondda Cynon Taff—which is meant to take the lead in establishing the new anti-drugs partnership—has played no part in making sure that we have a strong approach to deal with the issue. Is that because of political failure, and will my hon. Friend make sure that RCT gets its act together soon?

Don Touhig: I am aware that there have been problems with the operation of crime and disorder partnerships in Wales. Indeed, my hon. Friend the Member for Vale of Clwyd (Chris Ruane) raised the matter in a Westminster Hall debate a little while ago. I can tell my hon. Friend that £5 million has been provided since 2001 to the communities against drugs initiatives to support projects across Wales to tackle drug-related crime, and to disrupt the drug markets. I will, of course, ensure that my hon. Friend's comments about his local partnership are brought to the attention of my right hon. Friend the Home Secretary.

Elfyn Llwyd: The Home Office initiative Operation Tarian is proving a great success in the south Wales valleys. However, will the Minister have a word with the Secretary of State and perhaps liaise with the Home Office about the fact that the Home Office is contributing only £50,000 to that very important initiative? Unfortunately, that means that £3.2 million must be drawn down from other National Assembly budgets, including rehabilitation budgets. We already know that there is a huge waiting list in Wales for those resources. In some south Wales valleys, the typical waiting time is 18 months. With the best will in the world, I ask the Minister to liaise with the Home Office about bringing in some more money. Otherwise, it seems to me to be almost self-defeating.

Don Touhig: I note what the hon. Gentleman said about Operation Tarian. It is an important initiative. It was started by police authorities in south Wales, and it is supported by colleagues in the Assembly, and by funding from the Home Office. Indeed, I was involved in discussions with colleagues when the operation was set up. The House may not be aware that South Wales police were involved in a large operation last week. Heroin, crack cocaine, cannabis and ecstasy were seized, and 83 people were arrested. Operation Tarian is making an important contribution to the intelligence gathering that is needed to combat the problem. However, I take note of what the hon. Gentleman has said, and I shall make sure that the appropriate Departments are made aware of it.

Ian Lucas: I recently held talks with Wrexham magistrates, at which I learned that there has been a very positive response to the imposition of drug treatment and testing orders. Does my hon. Friend agree that it is essential for people to understand that substantial funding is necessary to safeguard the orders and make them effective? Will not any suggestion that funding might be reduced undermine one of the ways that we are beginning to get to grips with the scourge of drugs in our community?

Don Touhig: I agree with my hon. Friend. Substance abuse is not a simple problem. We must do everything that we can to break the cycle of drug misuse and criminal activity, but we must concentrate on three other initiatives—education, to prevent drug and substance misuse; treatment, including treatment for people who commit crime; and rehabilitation, to break the cycle. This year, £3 million has been allocated to drug and alcohol initiatives in Wales to enable 1,000 more people to access community detox facilities. We will need to expand that initiative, and I believe that my colleagues in the Assembly are working with the Home Office with that objective in mind.

Nigel Evans: Drugs are a bigger menace in Wales today than they were just five years ago. More people are hooked and dying, and the treatment for those who need it is totally inadequate. So what did the Government do? They demoted the drugs tsar, and then abolished the post. They removed all targets for reducing the number of people taking hard and soft drugs, and then reclassified cannabis from a class B drug to a class C drug. They have left the police and public confused about the law on the use of drugs. Even the annual drugs report has not been published since 2001. Is not the problem the fact that the Government do not have a strategy for dealing with drug abuse? Until they get one, more young people are going to get hooked, and to die. Is not it time that the Government got a proper strategy for drug abuse?

Don Touhig: The hon. Gentleman may be aware that the Government have provided £27 million of support for local initiatives across Wales. My colleagues in the Assembly provided a further £18 million over the next three years for initiatives, and the new community partnerships will work along those lines.
	It is a bit rich for the hon. Gentleman to make further demands when his party is committed to a 20 per cent. cut in public expenditure. What would that do for tackling the drug problem in Wales? His colleagues will have to give that answer to the people of Wales on 1 May, when once again they will be rejected.

Severnside Airport

Huw Edwards: What recent representations he has received concerning a proposed Severnside Airport.

Peter Hain: I have met representatives of the Severnside consortium, who briefed me on their proposals.

Huw Edwards: Does my right hon. Friend recall receiving from me representations that show that there is considerable opposition to the current proposals for Severnside airport on a man-made island in the Severn estuary? There is opposition from Monmouthshire county council and no support from the 18 airlines, including British Airways, that I have contacted, and I found majority opposition from the residents of Portskewett and Sudbrook in my constituency when I undertook a full household survey. Will my right hon. Friend study those representations and recommend to the Department of Transport that the proposal be rejected?

Peter Hain: I will certainly study those views. I am well aware of the concerns of residents in his local area, not least because he brought them to my attention a few weeks ago. In the consultation exercise that is being carried out by the Department of Transport—a White Paper will follow later this year—full account will be taken of environmental, safety and economic issues, as well as of the views of local residents. The Severnside consortium has an ambitious plan to relocate traffic from the south-east of England to that area, but the views of local residents must of course be taken into account.

Roger Williams: Does the Secretary of State still support the concept of a regional air service with Cardiff as its hub?

Peter Hain: Yes, I do. Regional airports already play a vital role in Wales and should play an even more vital role right across Wales, from north to south and from east to west. There is great potential for increasing air traffic in that way.

Paul Flynn: Does my right hon. Friend agree that international airports are good servants but atrocious neighbours? Would it not be right to use the Severn estuary, with its almost unique quality of having the second highest rise and fall of tide in the world, to generate electricity in a clean, benign and non-polluting way?

Peter Hain: As my hon. Friend knows, I am a keen enthusiast for renewable energy. The Severn estuary barrage was one of the issues that we examined during our consideration of the energy White Paper. It is hugely expensive, but there are opportunities for utilising tidal and wave power, and the Welsh coast and the Severn estuary may represent such an opportunity.

Local Government Finance

Simon Hughes: What discussions he has had in March on the effects of proposed council tax increases in Wales in April 2003.

Don Touhig: My right hon. Friend and I have discussions with many people and organisations about matters affecting Wales.

Simon Hughes: Will the Minister give us the latest information on the likely average increase in council tax in Wales in the current year? Does he agree that people in Wales particularly resent high increases if they feel that decisions are largely taken in Whitehall and the Wales Office, not by their local councils? Would he be willing to allow the Welsh Assembly to have power over the way in which local government finance is raised in Wales, and will he consider local income tax as a much fairer alternative?

Don Touhig: That is a very interesting proposition. I understand that the hon. Gentleman is hoping to stand for the office of Mayor of London. As he campaigns on this issue, he will no doubt explain to the people of London why the Lib Dem council in Southwark, supported by the Tories, has hiked the council tax by 9 per cent. He should compare that with an average council tax rise in Wales of 8 per cent. The message is simple—Lib Dem and Tory councils cost more: vote Labour on 1 May.

Jon Owen Jones: Has the Welsh Assembly had time to reflect on its decision to delay council elections for one year? In future, might it decide to allow council elections to concur with Assembly elections, as in Scotland? That might have a beneficial effect on council tax rises.

Don Touhig: I am not sure that I want to be led down that road. When the Assembly decided to delay the next council elections, there were extensive discussions among all parties. A decision was taken and I do not believe that the Assembly has any intention of changing the decision at this time.

Nigel Evans: In 1997, people living in a band D house in Merthyr Tydfil paid £569 in council tax. When they receive their council tax bills in just a couple of weeks' time, they will be paying £1,003. Does the Minister think that a reasonable increase?

Don Touhig: Some of us have longer memories than others. In the last two years of the Tory Government, council tax band D in Wales went up by 32 per cent. This year—thanks to the support of this Labour Government, working in partnership with the Labour Assembly—councils have received an extra 9 per cent. in support for public services. As I said earlier, the average council tax rise in Wales is 8 per cent. this year. One council, of course, has imposed a rise of well above that: Conservative-run Vale of Glamorgan, backed and kept in power by the nationalists, is putting up its council tax by 10 per cent. That is a clear message to the people of the Vale of Glamorgan come 1 May.

Nigel Evans: I asked whether it was a reasonable increase; I infer from his answer that the Minister thinks it is. In Blaenau Gwent, for instance, council tax has gone up by 78 per cent. since 1997. This year, people there face an 11 per cent. increase in their council tax, which will go up to £975. In Neath, the constituency of the Secretary of State for Wales, the increase since 1997 has been 56 per cent. In Cardiff, people face a rise of 12 per cent. this year, which is four times the rate of inflation. How are people on fixed incomes supposed to pay those huge rises? Do they cut down on food, stop going out or turn the heating off? Those are real questions for people. What advice would the Minister give them when they open their council tax bills in just a few weeks' time?

Don Touhig: The hon. Gentleman could at least do us the courtesy of getting his figures right. The figures are 9 per cent. and 11 per cent. for Blaenau Gwent and Cardiff.
	What would public services in Wales be like if they were subject to a 20 per cent. cut? Let me tell the House what they would be like. We would have one in five nurses taken out; one in five hospital wards closed; one in five teachers got rid of; one in five police officers got rid of; £155 million worth of cuts in every—[Interruption.]

Mr. Speaker: Order. Perhaps the Minister will not mention the election in Wales any more. He has used up his ration.

Rail Services

Jackie Lawrence: What recent discussions he has had with National Assembly Secretaries concerning rail services in Wales.

Peter Hain: Regular ones, to ensure improvements are made.

Jackie Lawrence: I welcome the £2.5 million that the Assembly has allocated to improve railway stations in Wales, but does the Secretary of State accept that if we want to improve rail services we will have to attack the Reading blockage, the signalling problems at Slough and the flooding in the Chipping Sodbury tunnel? Those factors are the cause of many of the delays. Will the Secretary of State discuss this issue with his Westminster colleagues and press for improvements? What we need is partnership, and not the drawbridge mentality of the nationalists.

Peter Hain: I could not agree more. These issues are being addressed through the record investment that is going into improving our railways. That includes investment in the Paddington to south-west Wales line. We are doubling our investment in rail infrastructure and rail services over the coming two years. If we got a Conservative Government back, they would cut rail investment by 20 per cent.

Hywel Williams: The very active and positive Cambrian coast railway liaison conference is made up of members from all parties and from none. They have been working hard but are continually disappointed that the small amount of investment needed to improve services on the Cambrian coast is withheld. Will the Secretary of State assure us that those services will be improved, as the cross-party Cambrian line support group has requested so often?

Peter Hain: We are certainly anxious to see further support and investment to improve rail services right across Wales, including the Cambrian service. We shall look at that. However, if nationalist policies were pursued and Wales was made independent, Wales would be bankrupt and—

Mr. Speaker: Order.

Albert Owen: The Secretary of State will be aware of the fact that Virgin Trains reneged on its proposal to run seven through trains from Holyhead to London from September of next year. Will he agree to meet a delegation of business men and stakeholders from my constituency so that we can put pressure on Virgin Trains to reconsider that decision, which will have a serious impact on tourism and the economy of my area?

Peter Hain: I shall be happy to meet that delegation, because I know of my hon. Friend's concern to improve rail services. Indeed, the people of Holyhead and people throughout Anglesey deserve improved rail services, which is what they will get under the Labour Government. I shall be happy to take up my hon. Friend's request.

Lembit �pik: While the Minister is being generous, and given the unsatisfactory service north to south and east to west in mid-Wales, will he be willing to accept representations from rail user groups about what might be done to improve the frequency and reliability of the service? Will he also give us an assurance that the Government have no plans for a real-terms cut to the subsidy for rail services in that area?

Peter Hain: We are increasing rail investment by record amounts. I know of the hon. Gentleman's concern about rail services in that area, and the Strategic Rail Authority is proposing additional services for the heart of Wales line, which will improve services in mid-Wales. I do not know how many other requests to meet delegations on rail services I shall get, but I shall be happy to receive the hon. Gentleman's.

Win Griffiths: Given that sometimes it is a wonder that we get to London[Interruption.]

Mr. Speaker: Order. There is far too much conversation.

Win Griffiths: Sometimes it is a wonder that regular rail users get to London on a Monday or get home on a Thursday. Will my right hon. Friend the Secretary of State call in the SRA, Railtrack and all the train operators to thrash out a strategy to get rid of all the problems that my hon. Friend the Member for Preseli Pembrokeshire (Mrs. Lawrence) referred to earlier?

Peter Hain: As a regular user of that service, I am well aware of the difficulties and how often delays occur. However, we are dealing with record under-investment over nearly 20 years of Conservative rule, which will take time to turn around. Investment in our rail services is being doubled over the next few years. That will continue for the rest of the decade and we shall see improvements on the London to south-west Wales line that will benefit my hon. Friend and me.

Terrorism

David Heath: What discussions he has had with (a) the National Assembly for Wales and (b) local authorities in Wales on contingency planning for a terrorist attack on nuclear installations in the Bristol channel.

Don Touhig: The lead responsibility for counteracting terrorism lies with my right hon. Friend the Home Secretary. However, security at civil nuclear facilities is a matter for the Department of Trade and Industry. The UK's civil nuclear sites apply stringent security measures, regulated by the DTI's Office for Civil Nuclear Security.
	Both the Wales Office and the Assembly are involved in national arrangements for dealing with the effects of any civil emergency. Within Wales the Assembly works jointly with local authorities to maintain a state of preparedness.

David Heath: I am grateful to the Minister for that reply. Is he aware that 15 years ago, when we were fighting proposals for the Hinkley C pressurised water reactor, we were told that the chances of an aircraft hitting a nuclear installation were so negligible as to be irrelevant? Few people would take that view now, so is the Minister satisfied with the contingency arrangements for nuclear installations, which, on Severnside, are the most concentrated in the country? Is he satisfied with the resources for the National Radiological Protection Board and is he sure that the emergency services on both sides of the Bristol channel are able to cope with a catastrophic emergency?

Don Touhig: The companies operating civil nuclear installations have always been required to have in place robust, detailed and well-rehearsed plans to respond to any radiological release. The plans involve emergency services and local authorities in the surrounding area and are regulated by the nuclear industry's inspectors, as the hon. Gentleman is probably aware. The arrangements were significantly enhanced following the Chernobyl disaster in 1986. Contingency plans were tested against the threat posed by a major incident in a live exercise at Bradwell on 10 May last year. The hon. Gentleman is right to say that we must always continue to maintain very high vigilance and a very high regard for those installations and ensure that they are properly cared for and properly protected, and I believe that we are doing the right thing in that respect.

Llew Smith: Does the Minister accept that the best long-term defence against terrorist attacks on nuclear installations is to rid Britain of its civil and military nuclear roles? What can we learn from the disaster at Chernobyl, as a result of which not only that community but even farms throughout Wales were devastated?

Don Touhig: No, I do not agree with the points that my hon. Friend makes.

James Gray: Until yesterday, the right hon. Member for Southampton, Itchen (Mr. Denham) was responsible for homeland defence. Who is now in charge of that?

Don Touhig: Those matters are, of course, ultimately the responsibility of the Home Secretary.

Climate Change Levy

Andrew Selous: What recent representations he has received about the effects of the climate change levy on manufacturing industry in Wales.

Don Touhig: My right hon. Friend the Secretary of State has received a number of representations from individual companies and groups representing business, including the CBI.

Andrew Selous: Will the Minister confirm that, on its introduction, the Treasury said that the climate change levy would be broadly neutral for business, that manufacturing has, in fact, suffered a 90 million net tax hit, that Wales is particularly hard hit with 28 per cent. of its gross domestic product dependent on manufacturing and, furthermore, that the Engineering Employers Federation's counter-proposals would lead to greater reductions in energy use and a lower cost to business in Wales and elsewhere? [Interruption.]

Mr. Speaker: Order. The House is far too noisy.

Don Touhig: The Government are committed to making Britain one of the most competitive business environments in the world. That has been demonstrated by the fact that our tax burden on business and industry is the lowest of all our major competitors, but we recognise, too, that business and industry must make a contribution to improve and protect our environment. I mentioned in my initial answer to the hon. Gentleman that my right hon. Friend the Secretary of State recently met representatives of the CBI. The director of the CBI in Wales fully understands the Government's position; nevertheless, my right hon. Friend took on board the points made by the director with regard to the climate change levy and, as a result, he is in discussion with my right hon. Friend the Chancellor of the Exchequer.

Alan Howarth: Does my hon. Friend accept that the climate change levy has been a problem for Corus? He will be acutely conscious, as I am, of the difficulties currently facing Corus. Will he join me in praising the achievements and spirit of the whole work force at Llanwern? Will he undertake to examine urgently, with colleagues in Wales and Whitehall, whether any aspect of public policy unnecessarily disadvantages Corus in doing its business? If he identifies one, will he act swiftly to deal with it?

Don Touhig: My right hon. Friend the Secretary of State for Wales has been involved in detailed discussions with the management of Corus and other Ministers about the company's concerns. He carried on that job of work from the former Secretary of State for Wales, who also played an important part in helping to secure a package when Corus announced its job losses. The Government will work in partnership with colleagues in the Assembly and with Corus in every way possible to avoid any further job losses at Llanwern.

Adam Price: Will the Minister specifically consider offering further concessions to the steel industry in relation to the climate change levy and take into account the industry's concerns about the effect of the landfill tax? Can he confirm that the UK Government have sought approval from the Commission for emergency state aid on a contingency basis, which the Dutch Government have already done?

Don Touhig: I can tell the hon. Gentleman that the Government have made available 30 million a year in incentives for organisations that volunteer to take part in the UK emissions trading scheme. We are working with the industry and colleagues in the European Union to ensure that we are doing the right thing and that that does not impact adversely on business and industry in Wales. I think that we are doing a good job in that respect.

PRIME MINISTER

The Prime Minister was asked

Engagements

David Rendel: If he will list his official engagements for Wednesday 19 March.

Tony Blair: This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I will have further such meetings later today.

David Rendel: Now that it seems inevitable that, sadly, there will be immense destruction in Iraq over the next few weeks, and given that the Select Committee on International Development reported earlier this year that less than half the necessary funds for the reconstruction of Afghanistan had been contributed, can the Prime Minister assure the House that he, the Chancellor of the Exchequer and the Secretary of State for International Development will ensure that sufficient funds for the reconstruction of Iraq are provided swiftly?

Tony Blair: First, I should say to the hon. Gentleman that the purpose of the reconstruction programme post conflict in Iraq is not, in fact, primarily to do with the consequences of any military conflict, but is actually to do with reconstructing the country after the years of Saddam Hussein and his rule. Secondly, I would say to him that, yes, we will ensure that the funds are availableindeed, funds have already been earmarked for the purposeand the Secretary of State for International Development, the Ministry of Defence and the Treasury are doing all that they can to make sure that we co-ordinate with American allies and also with other UN partners to ensure that the funds are available and also that the programme is available, so that in the post-conflict situation in Iraq the people of Iraq are given the future that they need.

Stuart Bell: Will the Prime Minister note that, at the present time in the Gulf, we have 37 Army chaplains, 12 RAF chaplains and 19 to 20 Royal Navy chaplains? Does that not reflect the great support of the churches for our armed services at this time? Should that not be reflected not only in this House, but in the country?

Tony Blair: I know that my hon. Friend, because of his special responsibilities and interests in this matter, is deeply knowledgeable about the armed forces chaplains. They do an excellent job for our armed forces. At this moment in particular, the thoughts of the whole House, no matter what position we take on Iraq and the conflict, will be with our armed forces wishing them well and wishing them safety.

Iain Duncan Smith: Following last night's vote, does the Prime Minister agree that British forces serving in the Gulf should know that, irrespective of how individual MPs or even parties voted, the whole House of Commons backs them and wishes them Godspeed and a safe return?

Tony Blair: I am sure that the whole House will endorse those sentiments. Whatever positions people have takenand we understand the reasons for thatI know that everyone in this House wishes our armed forces well, wishes that, if there is conflict, it will be over as quickly and as successfully as possible and would like to pay tribute to their dedication and commitment on behalf of this country.

Iain Duncan Smith: As Saddam Hussein has rejected every single offer to disarm or leave the country, is it now a reality that the removal of Saddam Hussein has become an explicit war aim?

Tony Blair: It is the case that if the only means of achieving the disarmament of Iraq of weapons of mass destruction is the removal of the regime, then the removal of the regime of course has to be our objective. It is important that we realise that we have come to this position because we have given every opportunity for Saddam voluntarily to disarm, but the will not only of this country but of the United Nations now has to be upheld.

Iain Duncan Smith: Given the Prime Minister's answer, the whole House also will have heard the statement by President Bush that any Iraqi commander who commits a war crime will be prosecuted. Will he confirm that that dictum goes right to the top and, despite some reports of immunity, includes Saddam Hussein himself?

Tony Blair: There was a possibility, if Saddam Hussein was prepared to leave voluntarily, quit Iraq and spare his people the conflict, that we could have ensured that that happened. The circumstances in relation to any immunity might then have been different, but it is reasonably clear, I think, that that will not happen. I think that it is very important that those in senior positions of responsibility in Saddam Hussein's regime realise that they will be held accountable for what they have done.

Iain Duncan Smith: When I asked the Prime Minister in the past about his plans for post-conflict Iraq, he was, quite legitimately and understandably, reluctant to give full answers because he would not have wanted to give the impression that conflict was inevitable. Now that war is looming and Saddam Hussein's days are clearly numbered, will he tell us what plans there are to put in place a civilian representative Government in Iraq?

Tony Blair: We are in discussion now with not just the United States, but other allies and the United Nations. We want to ensure that any post-conflict authority in Iraq is endorsed and authorised by a new United Nations resolution, and I think that that will be an important part of bringing the international community back together again.
	We have set out a vision statement for Iraq and the Iraqi people, and it might help if I highlight one or two of its aspects. First, we will support the Iraqi people in their desire for
	a unified Iraq within its current borders,
	and we will protect their territorial integrity. Secondly, we will protect their wealth, and I repeat again that any money from Iraqi oil will go into a UN-administered trust fund for the benefit of the Iraqi people. There should be freedom in
	an Iraq which respects fundamental human rights, including freedom of thought, conscience and religion and the dignity of family life,
	and there should be freedom from the fear of arbitrary arrest. There should also be an
	Iraq respecting the rule of law, whose government reflects the diversity and choice of its population,
	and who help to rebuild Iraq, for the Iraqi people, on the basis of unifying the Iraqi people. Those principles of peace, prosperity, freedom and good government will go some way toward showing that if there is a conflict and Saddam Hussein is removed, the future for the Iraqi people will be brighter and better as a result.

Marsha Singh: Now that the Prime Minister has received a mandate for war, will he take this opportunity to reassure the world that it is a war against Saddam Hussein, and not the Iraqi people and Muslims? Will he also reassure our Muslim communities that he will not allow them to be scapegoats for anything that might happen in the Gulf?

Tony Blair: I thank my hon. Friend for what he said because I know that it will be heard and considered closely by people in this country and abroad. Let me make it quite clear that our quarrel is not with the Iraqi people because the Iraqi people are the principal victims of Saddam Hussein. Our quarrel is with Saddam. He is the person who has been responsible for killing thousandsindeed, hundreds of thousandsof Muslim people both in his wars and through his internal repression. I know that the vast majority of the Muslim community in this country are good, law-abiding people who contribute an immense amount to our country, and we are proud of our country as a multicultural and multiracial society.

Charles Kennedy: As, of course, the whole House will associate itself with the expressions of support for our armed forces and their families at home, may I ask the Prime Minister about the related issue arising from the past few days: the middle east road map? What is the status of that in the eyes of the British Government, given that the Israelis seem to feel that it can be altered as it progresses?

Tony Blair: Our commitment is total to the middle east peace process and to the road map being published. That is the clear commitment that has been given not only on our behalf, but on behalf of the President of the United States. Of course, both the Palestinian Authority and the Israeli Government can make their comments, but the road map is not simply a set of principles, but a detailed process for reaching the point of establishing a viable Palestinian state and an Israel that is confident of its security and recognised by all its neighbours. We are totally committed to ensuring that the road map is fulfilled.

Charles Kennedy: Will the Prime Minister also reassure the House that he will maintain pressure, as he has already, on the American Administration to ensure that they continue to back the momentum for that process?

Tony Blair: It is worth quoting what the President of the United States said last Friday on that subject because it indicates the degree of commitment that he has given. He said:
	The government of Israel, as the terror threat is removed and security improves, must take concrete steps to support the emergence of a viable and credible Palestinian state, and to work as quickly as possible toward a final status agreement.
	He went on to say:
	We expect . . . a Palestinian Prime Minister will be confirmed soon. Immediately upon confirmation, the road map for peace will be given to the Palestinians and the Israelis.
	He then said:
	America is committed, and I am personally committed, to implementing our road map toward peace.
	That is his commitment and my commitment, and we will work hard to ensure that it is delivered.

Alice Mahon: It is widely reported in today's newspapers that the United States intends to use a new bomb that will melt the Iraqi communications systems. Will this bomb also melt the equipment that is used in hospitals and that runs the water and electricity supplies in Baghdad? Will the Prime Minister assure us that it does not melt people?

Tony Blair: In any military conflict, we will operate in accordance with international law. Any weapons or munitions that are used will be in accordance with international law. I assure my hon. Friend that we will do everything that we can to minimise civilian casualties and, indeed, to maximise the possibilities of a swift and successful conclusion to any conflict.

Andrew Rosindell: While our thoughts and prayers are with our brave servicemen in the Gulf, will the Prime Minister reflect on one thing? Given the disgraceful and spineless attitude of the French Government, is it not highly dangerous and irresponsible to contemplate tying British defences into a European common defence and security policy?

Tony Blair: If that was a bid for the Foreign Office badge of diplomacy, it somewhat failed. I simply say to the hon. Gentleman that it is important that we make sure that we participate fully in any debates about European defence. The purpose of our participation is to make sure that European defence is fully compatible with our membership of NATO. I appreciate that there is a disagreement between us and the Opposition, but I genuinely believe that the worst thing that we could do in any debate about European defence would be to leave the chair empty. If I can put it more diplomatically than the hon. Gentleman, those who might oppose our vision of how European defence matures over years would then be strengthened.

Martin Caton: International humanitarian law prohibits military attack that fails to discriminate between combatants and non-combatants or that disproportionately impacts on civilians. Can my right hon. Friend assure me that, in the war on Iraq that the House sanctioned last night, we will not be employing cluster bombs and that electricity, transport and water infrastructure will not be targeted?

Tony Blair: I simply say in relation to any weapons or munitions that we use that we will use only those that are in accordance with international law and with the Geneva convention. That is the responsibility of the Government and is the commitment of this Government and has been of other British Governments in the past. We will do everything that we can to minimise civilian casualties. The reason why, in respect of any military action that we take, we get legal advice not merely on the military action itself but on the targeting is to make sure that that happens. Of course, I understand that, if there is conflict, there will be civilian casualties. That, I am afraid, is in the nature of any conflict, but we will do our best to minimise them. However, I point out to my hon. Friend that civilian casualties in Iraq are occurring every day as a result of the rule of Saddam Hussein. He will be responsible for many, many more deaths even in one year than we will be in any conflict.

Peter Robinson: Can the Prime Minister tell the House anything of his plans in terms of the state of readiness for homeland defence? What state of a war footing is the United Kingdom on in the now more likely event of international terrorism?

Tony Blair: We have made detailed preparations for the possibility of any terrorist attack, as I am sure the hon. Gentleman knows. We have also spent several hundred million pounds ensuring that we have both the equipment and the planning in place. I will not go into the details of each part of that, but I assure him that we are well aware of the risk that this countryindeed, all countriessuffers and faces at the moment. We are doing everything that we can to prepare against it.

Chris Ruane: The UK, along with dozens of other nations, stood shoulder to shoulder with the US over Afghanistan and now Iraq. That loyalty has been rewarded by the Bush Administration with the imposition of steel tariffs, the withdrawal from test ban treaties, the introduction of farm subsidies in America, and contempt for the International Criminal Court. The President rubbished and reneged on the Kyoto and Johannesburg treaties, and scuppered my right hon. Friend's attempts to open dialogue with the Palestinians in January. Can my right hon. Friend use his now legendary powers of persuasion to convince President Bush to develop a world vision worthy of his great nation?

Tony Blair: I gather from my hon. Friend's remarks that he is not a total fan of President Bush. There are important things that President Bush has agreed to, and it is as well to balance my hon. Friend's remarks with those. First, President Bush took the case of Iraq to the United Nations. He was asked to do so and did so, and he agreed resolution 1441. I say and say again that it was not he who walked away from that deal.
	Secondly, in respect of the middle east peace process, my hon. Friend will have heard the words that I spoke a moment or two ago, quoting President Bush and his commitment to that. He is the first American President to commit himself to the two-state solution of a state of Israel and a viable Palestinian state.
	We are working closely on a new UN resolution in relation to reconstruction.
	There are disagreements about trade, but those are familiar disagreements, not merely with the present American Administration, but with previous American Administrations. A couple of years ago, under the previous Administration of a Democrat President, I spent a large part of my time dealing with the issue of cashmere sweaters. Those things happen, and America is not the only country with which we have the odd trade disagreement. I understand what my hon. Friend is saying. It is important that we use our influence to develop that global agenda, and I believe that we can do so.

Iain Duncan Smith: Does the defeat of the Government's asylum legislation in the Court of Appeal yesterday make the achievement of the Prime Minister's target of halving asylum applications by September more or less likely?

Tony Blair: I am pleased to say that because we won on the legal principle, that is not affected.

Iain Duncan Smith: The Prime Minister is the only person who can claim defeat in the Court of Appeal as a triumph. The asylum organisations have all said that the policy is now in tatters. Surely this is the latest setback for a Government who introduced vouchers, then scrapped them; scrapped the white list, then re-introduced it; and have been forced by the courts almost weekly to change their policy. Small wonder that last Friday the United Nations High Commissioner for Refugees published a report that shows that for the second year running Britain has the worst record of all the industrialised nations. Is it not true that under the present Prime Minister we have become the asylum capital of the world?

Tony Blair: First, the right hon. Gentleman is wrong about the judgment. The judgment supported the principle that if people do not claim in time, they do not get their benefit. There are changes to the procedures in individual cases that we can make without disturbing that basic principle. Of course, the right hon. Gentleman will hold me to account on the pledge and commitment that we have given. If he looks carefully at the asylum figures for the end of last year, once the new asylum legislation came into effect, he will see that there was already a 25 per cent. drop in asylum claims. I am pleased to say that, as will become apparent in due course, that progress has continued well.

Lynne Jones: Saddam Hussein has been offered immunity from prosecution if he leaves Iraq. On what authority was that offer made, what message does it send to other corrupt regimes, and what is my right hon. Friend's strategy for a return to a world order in which decisions are taken lawfully through the UN, rather than by the world's superpower? Or is it too late? With his help, has the foundation stone for the pax Americana already been laid?

Tony Blair: First, the reason why we were prepared to offer such a possibility was to avoid war, which is, after all, what I thought my hon. Friend wanted. If she was saying that President Bush had been too soft and should have said that we would remove Saddam Hussein in any event, I could understand that. We wanted to try to avoid conflict by having him voluntarily disarm. Then, if he refused to do so, we were prepared to give a further chance to resolve the matter peacefully by getting him to leave the country. Now we are faced with the prospect of leaving him in place without disarming him, or making sure that we remove him from power. I earnestly ask my hon. Friend to consider this.
	If we remove Saddam from power, as I believe we will have to because it is the only way of disarming Iraq of weapons of mass destruction, the people who will rejoice most will be the Iraqi people who will be free of a murderous tyrant who has done nothing but damage to his country. If she wants to know what Iraq could be like, she should talk to the people in northern Iraq who, because of British and American pilots in the no-fly zone, have been able to build something of their country, and she will see that the true impulse of the Iraqi people is for greater freedom, democracy, prosperity and the rule of law.

John Randall: What lessons does the Prime Minister think could be learnt for a post-war Iraq from the current situation in Kosovo?

Tony Blair: First, I would say that people in Kosovo, as people in Afghanistan, whatever the difficulties, are infinitely better for being removed from the rule of brutal dictators, whether Milosovic or the Taliban. Secondly, we must stay in for the long term. It will be easier over time, but in Kosovo, as in Afghanistan, we cannot make a short-term commitment. We must make a long-term commitment to reconstruction and rebuilding those countries. But for all the difficulties in the Balkans at the moment, most obviously after the appalling assassination of the Serbian Prime Minister recently, the Balkans is at a point where it has a better prospect for peace and prosperity than probably at any time in the past 100 years. That is because we were prepared to take military action in order to remove the regime that was preventing that prosperity from coming about.

Phil Hope: The Prime Minister will be aware that it was this Government who introduced the historic national minimum wage in the teeth of fierce opposition from the Conservative party. On behalf of temporary workers, particularly in my Corby constituency, may I thank the Government for the announcement today that the national minimum wage is to rise by three times the rate of inflation? But will my right hon. Friend consider lowering the adult rate so that 18-year-olds can qualify for the higher rate and applying a youth rate to 16 and 17-year-olds to prevent exploitation of young people in the workplace?

Tony Blair: The point that my hon. Friend makes about young people is one that is often made. Our concern has always been to ensure that we do nothing to disturb the employment prospects of young people, but we keep the matter under review. I am pleased to say that we have published the fourth report from the independent Low Pay Commission and, as he rightly says, it will mean that the minimum wage for adults rises from the present 4.20 to 4.50 in October, and then to 4.85 in October 2004. More than 1 million people are now benefiting from the minimum wage, many of them low-paid women workers, and, combined with the working families tax credit, literally thousands of families throughout the country in every constituency are benefiting from this Labour Government's drive towards greater equality.

Chris Grayling: During the next few weeks our humanitarian response to the Iraqi crisis will be as important as our military one. Given the monumental mess that the Secretary of State for International Development has made this week of her own position, what confidence can we have that she is now the right person to do that job?

Tony Blair: We can have the confidence of the experience over many years in which that Department has gained a reputation throughout the world for the humanitarian assistance that it has given. That is as a result of the co-operation that has taken place not just between that Department and other Departments, but with the United Nations and with the American Government. I can assure the hon. Gentleman that we will put every effort into the humanitarian assistance that is required, and we will make sure, in particular, that as military action develops we are able to take care of the Iraqi people in a way that Saddam Hussein has not been able to do.

Gordon Marsden: The Prime Minister, in his powerful speech yesterday and again in his response to the Leader of the Opposition this lunchtime, has confirmed that it is crucial that any post-war settlement for Saddam Hussein's Iraq involves the UN in the administration and control of the oil revenues. We all know that during the next few weeks the logistical pressures on the Government, particularly on the Prime Minister, will be enormous, so can he reassure the House that he will talk to the Foreign Secretary to insist that the detail of that arrangement is pursued with the utmost vigour with the Americans and involving the EU partners, both prospective from the enlargement countries and those that we have at the moment, including those who did not agree with the Government at the Security Council?

Tony Blair: There are two aspects. The first is the humanitarian relief that is necessary as military action gets under way, on which the Department for International Development, the Foreign Office and the Ministry of Defence are working closely, obviously, with our military allies, particularly the US. Indeed, I took a meeting on that issue this morning. The second aspect will be humanitarian assistance in the post-conflict situation, which should be done under a UN resolution, as in relation to the administration, and of course we want to involve as many countries as possible.

Mark Oaten: Does the Prime Minister believe that the United Nations needs to reform? If so, in what way should it reform, and what role will he have in that?

Tony Blair: There are issues, obviously, in relation to the UN Security Council and reform of it, which we will have to discuss with others, but the issue is not really institutional; it is whether we can construct a sufficiently strong partnership between Europe and America and a global agenda around which people can unite. If they cannot unite politically, no amount of institutional tinkering will help us resolve those problems. That is why, at the end of this, we need a period of reflection to see how we put that partnership back together, and how we construct the global agenda that would bring in a lot more people to our way of thinking. That, whatever the institutional arguments in the UN, is what is essential.

Frank Cook: Now that military units are moving into what was previously the demilitarised zone in Kuwait and Iraq, will my right hon. Friend offer the House an assurance today that correct records and registers of inoculations, medication administered and weapons used in different sectors will be kept so that the parents of serving men and women can be assured that the right kind of inquiries can be made in the event of any condition arising akin to that which is called Gulf war syndrome?

Tony Blair: I am sure that my hon. Friend's point is justified. I know that procedures are already in place to do that, and, if he will allow me, I will write to him setting those out in detail. His point, however, is obviously important for the security and safety of our armed forces personnel.

James Gray: Despite what the Prime Minister said to my hon. Friend the Member for Romford (Mr. Rosindell) a moment ago, the fact is that a common European defence policy is central to the new draft constitution for Europe. Why will he not allow the people of Britain the right to have a referendum so that they can have their say on the matter?

Tony Blair: Probably for the same reason that the Conservatives did not have one on Maastricht[Interruption.] I know that they have changed a little bit in the meantime[Hon. Members: Oh.] May I ask Conservative Members to please sort this matter out among themselves, and come back later? The purpose of European defence is in relation to circumstances in which NATO does not want to undertake an operation but European defence has the capability of doing so.

James Gray: indicated dissent.

Tony Blair: The hon. Gentleman shakes his head, but that is true. The best example of that is Bosnia in the early 1990s. Because, at that point, America did not want to become engaged, we did not have the capability of protecting people in Bosnia. As a result of that, thousands of people died, and we are still in Bosnia more than 10 years later.

Tam Dalyell: Were cathedrals such as Durham, Lincoln or Wells to be damaged, what would we feel? What precautions are being taken about Kerbala, Najaf, Ur, Hatra and the other great sites? That will be difficult, given that, as at Samarra last time, Saddam may place military objects near the ancient sites.

Tony Blair: I am glad that my hon. Friend recognises the propensity towards total irresponsibility of Saddam. I assure him that we are fully committed to the protection of cultural property. That is not merely the Government's position: we are also committed to that under the Geneva conventions. I understand that the Foreign Secretary has talked to him about that, and we will do everything that we can to make sure that sites of cultural or religious significance are properly and fully protected.

Lembit �pik: On a domestic matter, does the Prime Minister support in principle the devolution of student funding arrangements to the Welsh Assembly, given that the Labour-Liberal Democrat partnership has requested that?

Tony Blair: The Secretary of State for Wales informs me that discussions about the issue are under way.

Iraq (Humanitarian Aid)

Caroline Spelman: To ask the Secretary of State for International Development if she will make a statement in response to the Select Committee on International Development's report on humanitarian contingency planning for Iraq.

Mike O'Brien: rose

Hon. Members: Where is she?

Mr. Speaker: Order. The hon. Member for Meriden (Mrs. Spelman) asked for an urgent question, which I have granted. I am not responsible for the identity of the Minister who comes to the Dispatch Box. [Interruption.] Order. He is a very good Minister.

Mike O'Brien: I apologise on behalf of my right hon. Friend the Secretary of State for International Development, who is doing her job in New York today discussing[Interruption.]

Mr. Speaker: Order. Mr. Fabricant, you get very excited at times. We are considering a serious matter. I have granted the urgent question and I can stop it if such behaviour continues in the Chamber. The hon. Member for Meriden asked for the urgent question and she is happy with the Minister.

Mike O'Brien: Thank you, Mr. Speaker. As you say, the matter is serious and my right hon. Friend the Secretary of State for International Development has asked me to reply to this important question about the way in which we tackle the crisis in Iraq.
	The Government strongly welcome the Select Committee on International Development's fourth report, which was presented to the House a week ago. We will give a detailed response to its various recommendations in due course. However, one of the crucial matters that it raises is the way in which the Government would move forward in the immediate post-conflict situation to try to resolve some of the humanitarian issues, and especially whether we would seek a United Nations resolutionor, indeed, more than oneto take the process forward.
	I confirm that we shall seek a further resolution to deal with the humanitarian issues. We shall try to transfer the oil-for-food programme to the United Nations Secretary-General to enable him to keep the process functioning and use UN facilities to do that. We will also seek a new UN resolution to provide authority for reconstruction and development work, and a proper mandate for any interim authority that is likely to operate in the territory of Iraq when Saddam Hussein is removed. We will also try to ensure the rapid delivery of humanitarian aid, to affirm Iraq's territorial integrity and to allow UN sanctions to be lifted, thus enabling food and other necessary items to arrive.
	We shall also enable an international reconstruction programme to facilitate the use of oil revenues for the benefit of the Iraqi people and to endorse a post-conflict administration in Iraq, which will lead to a representative Government who would uphold human rights and rule of law for all Iraqis.

Caroline Spelman: Thank you, Mr. Speaker, for granting this urgent question on a serious and pressing matter. We appreciate that the Secretary of State for International Development is on her way to the United Nations in New York, as the Foreign Secretary announced, to seek a fresh Security Council resolution. That was contained in the text of the motion that we debated yesterday. We wish her success. But we are surprised that the answers to our question are to be given by a Foreign Office Minister, given that the Select Committee report calls for an immediate statement from the Department for International Development. Given that the Under-Secretary for that Department is present, it appears to us that there has been some dispute about who should answer the question.
	The Secretary of State issued a written statement last Thursday, but it fell far short of responding to the 23 recommendations and conclusions in the Select Committee report. As it says on page 2 of the report, in the first stages of any conflict it is the military forces that will have primary responsibility for the initial delivery of humanitarian assistance. Is the Minister aware, however, of the concern of the non-governmental organisationssome of which are already in Iraq and the surrounding countries, ready to helpabout the blurring of responsibility between military action and humanitarian relief?
	The report is highly critical of the lack of consultation with the NGOs; indeed, we understand that such consultation has commenced only in the last two weeks. What is being done to improve information sharing with NGOs and to co-ordinate the UK and US aid agencies? Who is co-ordinating work with the military? Is it the Department for International Development, the Ministry of Defence, USAID, or the US Department of Defence? We need to know who is co-ordinating this work.
	It is reported that the oil-for-food programme, which has been providing 60 per cent. of the Iraqi population with food aid at a cost of $250 million a month, has been suspended. What assessment has the Department for International Development made of how to substitute food relief on such a large scale? In a written answer to the Chairman of the Select Committee on International Development, it was stated that DFID had no more contingency funds available for 200203, although the Secretary of State has said that the Chancellor has allocated an additional 10 million. We understand, however, that the Ministry of Defence has been granted an additional 50 million for humanitarian relief purposes. Does this mean that the Ministry of Defence will take the lead on the humanitarian side in the early stages?
	What estimate have the Government made of the total sum that will be required to finance a meaningful post-war reconstruction of Iraq, and for how many years do they estimate that such a programme will continue? The International Development Committee concluded that it was as yet not convinced that there was, to use the Prime Minister's words,
	a humanitarian plan that is every bit as viable and well worked out as a military plan.
	We wholeheartedly agree with that conclusion. When will the Secretary of State herself make a statement to the House to prove us wrong?

Mike O'Brien: May I first deal with why a Foreign Office Minister is dealing with this matter? I was in Washington last week, talking to USAID about precisely this issue, and discussing with the US Administration some of the terms of the resolutions that we will seek to put to the United Nations. It is currently envisaged that we will be putting at least two such resolutions to the UN. The first will deal with the immediate issues relating to the oil-for-food programme and humanitarian assistance. A further resolution will deal with some of the more complex issues relating to the humanitarian issues that will arise in the months to come. Both resolutions follow from the recommendations made in the report.
	I hope that I have dealt at least to some extent with why I am answering rather than my hon. Friend the Under-Secretary of State for International Development, although no doubt I have not done so to the hon. Lady's satisfaction.
	The 23 recommendations are being examined, and a full and detailed response will be made in due course.
	The non-governmental organisations want to ensure that they are fully apprised of the developing situation. Through DFID, we have been holding weekly meetings with the NGOs. One of their complaints is that they do not know all the details of precisely what will happen at various stages. There has of course been concern about the revealing of some military operations, but I think that we can now be much more open with the NGOs about what is likely to happen, and deal with many of the questions that they have been asking. I hope that the meetings will enable them to feel that they are receiving the information that they want.
	The hon. Lady asked who was co-ordinating the aid with the military. A number of steps are being taken. DFID has two advisers on humanitarian issues, who have been posted with 1 Division and will work with the military. They are experts on not just human rights but humanitarian issues applying to the military. The military will be the first in there, and are responsible for ensuring that they operate in a proper humanitarian context. There is also a humanitarian expert from DFID with the Office of Reconstruction and Humanitarian AssistanceORHAthe American organisation that expects to administer the post-conflict situation.
	The key problem is that 60 per cent. of Iraqis depend on the oil-for-food programme because of the way in which Saddam Hussein has run the country. It is crucial for the programme to go on functioning. The UN resolution under discussion is intended to ensure that it does so, and we shall be transferring responsibilities for the administration of the system to the UN Secretary-General.
	As for resources, 100 million of bilateral humanitarian aid has been allocated since 1991. There is 10 million of new money for the contingency plans of the UN agencies. The Department has secured 70 million from the contingency reserve, and the military have a further 30 million for humanitarian and human rights purposes. The military will have responsibility at the beginning for ensuring the early delivery of humanitarian aid, which is why they have that 30 million. While the military operations are in progress they will also do humanitarian work, which will be followed up by the NGOs as security is established. The UN will then be brought in to ensure that the whole process is administered properly. There will, therefore, be proper and effective co-ordination.
	It was clear from my discussions with USAID thatalong with DFID, for which it has nothing but praiseit has a detailed humanitarian plan to ensure that the various possible post-conflict scenarios can be dealt with. The Committee was worried that there might have been no detailed planning, but according to what I see and have been able to establish from discussions between DFID and USAID, the planning has been done and the humanitarian effort will be conducted properly.

Jenny Tonge: I congratulate the hon. Member for Meriden (Mrs. Spelman) on tabling this urgent question, and I pay tribute to the work that she has done on this issue over many weeks in the run-up to this crisis. In the light of this morning's somewhat cobbled together response, I am quite relieved that the Secretary of State is staying in her post for the next few weekseven if she will be incarcerated in the Tower of London come July.
	The humanitarian situation is going to be dire, and we demand to know, and should have known long before this, exactly what the Department's contingency plans are. I want to move the Minister on to post-conflict reconstruction. It seems to us that the USA already has very advanced plans, even to the extent of awarding contracts to American companies. What part is Britain playing in post-conflict reconstruction, and what British companies will play a part in it? Exactly how much money are the British Government going to spend on post-conflict humanitarian aid or reconstruction? Can we have an assurance that that money will not come out of DFID's budget, which is meant for the very poorest people in the world? Finally, can we also have an assurance that the oil revenues that we are told will be put in trust for the people of Iraq will not be used to repair the damage done by American bombers in the next few weeks?

Mike O'Brien: I confirm that, as part of the UN resolutions, we want to make it very clear that every single penny of the oil money that has not been plundered by Saddam Hussein already should go to the people of Iraq. It is very clear that the discussions that my right hon. Friend the Secretary of State is having in New York and in Washington are in order to ensure that the resources are available to deal with the post-conflict situation, and that the oil money that will be put in trust for the people of Iraq will be deployed exclusively for their benefit. We want to ensure, and to be quite unequivocal, that that is our intention.
	On British companies, USAID has at this stage used primarily American resources to let a number of contracts to American companies. We have received reassurance from the US Administration that many of those companies will subcontract up to 50 per cent. of the work that they will do as part of the humanitarian response, and that will be available to other countries to bid for. USAID assured me that the country that it works with most effectively is Britain, and that the Department that it works with most effectively is DFID. So British companies currently operating with DFID and other Government Departments will be able to undertake, and to bid for, contracts through the American companies. We are very conscious of this issue, and my right hon. Friend the Secretary of State will discuss the detail of how this will be done in Washington.
	The hon. Lady asked exactly how much money will be spent, and she is rightly concerned about the idea that resources intended for the very poorest might be diverted elsewhere. It is our intention that that should not happen, and, as I have said there is provision in the contingency reserve. We want to protect the money that is already being applied for the very poorest, and to ensure that those resources are maintained and allocated properly. However, we also want to ensure that we deal with our responsibilities to the people of Iraq, and we will do so.

Joan Ruddock: My hon. Friend will be aware of the consequences of the use of cluster bombs and depleted uranium weapons in the Gulf war. Nearly 2,000 Kuwaitis have been killed or injured since that war by exploding bombs, and there are many birth defects and cancers in Iraq. Ministers have failed to deny that such weapons will be used in the coming conflict. Assuming that they are used, what special arrangements will be made to deal with their humanitarian consequences?

Mike O'Brien: I have seen in Afghanistan some of the damage that can be done by the weapons deployed in conflict situations. It is important that we support the good work being done by various NGOs in trying to ensure that there is a proper clean-up of the results of conflict. As my hon. Friend will know, the Ottawa agreement does not make the use of cluster bombs unlawful. At this stage, I cannot say what the intentions are in respect of those weapons. However, when it comes to targeting, we are determined that the coalition forces will do everything possible to ensure that they avoid civilian casualties, and to avoid creating circumstances that will cause civilian casualties in the aftermath of a conflict. We are very conscious of the matter, and we will seek to deal with it.

Tony Baldry: I have two straightforward questions for the Minister, about food security and internally displaced people. It is estimated that, between now and the end of March, 460,000 tonnes of food aid will be needed in Iraq. Only a third of that amount is immediately available. How is the rest to be funded and delivered?
	On IDPs, practically no provision has yet been made to provide refuges for people internally displaced as a result of the conflict in Iraq. Who is getting a grip on providing and funding such refuges?

Mike O'Brien: A lot of planning has been done on food security. We have talked to the various NGOs that may have to deal with some of the IDPs, and to the countries that may be affected as people try to move towards their borders. We have been seeking agreements with other countries about how they will respond to the refugees coming towards their borders. We have also been talking to the military, who will obviously come across IDPs very quickly. We have discussed how they will ensure that those people's safety is guaranteed and how they will ensure that IDPs get the humanitarian aid that they need as quickly as possible. There are plans in place, therefore, to deal with both the issues that the hon. Gentleman raised, but I shall ask my right hon. Friend the Secretary of State to give him a more detailed response.

Ann Clwyd: As my hon. Friend knows, thousands of Kurds died unnecessarily in 1991 because neighbouring countries shut their borders. That underlines the point made by the Chairman of the Select Committee on International Development, the hon. Member for Banbury (Tony Baldry). Turkey and Syria shut their borders, but Iran was the exception. That has been known for some time. I understand that my hon. Friend the Minister is standing in, so I shall not press him too hard on the matter, but I am sure that somebody will have had talks with the neighbouring countries by now. I am sure that the House is keen to know what the response has been.
	Secondly, the Kurds are already moving out of the area, heading towards the mountains and the villages where their relatives are. The UN forces have gone, leaving the Kurds with the keys to the doors of the buildings where there are food supplies, blankets and tents. However, they have not left any way to transport those items. This is an urgent matter, and I hope that the Minister will look into it very soon.

Mike O'Brien: Obviously, the situation in the north, where the Kurds are, is somewhat better than elsewhere in Iraq. There at least we can make some provision to deal with some of the humanitarian issues involved. We are in discussion with representatives of the Kurds in the north about how to go about that, and how best to ensure that they can deal with any refugees who come their way.
	We do not anticipate that large numbers of people will seek to cross the Turkish border. I spoke to Syria's President Bashar al-Assad a couple of weeks ago, about the circumstances in relation to that country. At the moment, although they are not anxious to have large numbers of people cross their border, the Syrians are making some provision to assist the ones who may come in Syria's direction.
	We anticipate that most people will head towards Iran. I have also talked to the Iranian Foreign Minister and others about how Iran will deal with that eventuality. The Iranians are working with us to minimise the problems that refugees who go towards Iran may face.
	There is a lot of discussion going on, with Syria and Iran, and, obviously, with Kuwait. We are also talking to the people who are in control in the Kurdish area of northern Iraq.

Cheryl Gillan: The Minister will realise that his handling of the urgent question today is not inspiring confidence. His reply to my hon. Friend the Member for Banbury (Tony Baldry) on IDPs was not good. In the previous Gulf conflict, the western relief programme was hampered by the absence of UN High Commissioner for Refugees personnel. The UNHCR did not play its usual co-ordination rolewhich we are all concerned about this timebecause its mandate did not cover IDPs. Will the Minister say whether that is still true, or will the UNCHR be able to play its full role in any relief programme, irrespective of the status of those people?

Mike O'Brien: The International Committee of the Red Cross will obviously have an important role in the whole process, as will the UNHCR. Those organisations clearly have a responsibility, and there is no question but that they will accept it. Obviously, some of the organisations were reluctant to enter into discussions at too early a stage, as they needed to cover their international positions. However, we are now in a position to enter into detailed discussions with them. We have started preliminary discussions already. We will follow up on those, and ensure that these matters are dealt with.
	The hon. Lady began her question with some rather curmudgeonly remarks, and I am sorry to disappoint her. However, we are trying to ensure that we deal with these matters seriously. If she wants to make points that are rather silly and pathetic, that is a matter for her.

Shaun Woodward: We have been told that Saddam Hussein has put in place a military plan to divide his country into quarters. There is no doubt that that will make it extremely difficult for people to move around inside Iraq. Given what my hon. Friend the Member for Cynon Valley (Ann Clwyd) said about the movement of people to the borders, does my hon. Friend the Minister think that there is a really urgent need to revisit the negotiations with neighbouring states about the acceptance of refugees? Is there not an urgent need that food, medicine and shelter be provided for the people who arrive at those borders?

Mike O'Brien: Substantial negotiations have already been held with each of the Governments involved about matters of food and shelter. My hon. Friend is right to say that Saddam Hussein's apparent proposals for deployment of his military forces may make it difficult for some refugees to flee. We do not know yet how he will try to manage that deployment, but we will certainly guarantee to talk to the adjoining countries to ensure that they are aware of the support that we can provide. We will also ensure that the UN agencies and the other NGOs are engaged, and we will do everything that we can to protect the humanitarian needs of all those who have to flee from any conflict.

Martin Smyth: Some people are worried about what our troops might be doing when they go into the territories that the House is discussing but, as in the past, so in the future, they will be working to help the people who need their help. I am sure that the Minister will agree about that. Does he share my concern that Oxfam representatives, speaking for the NGOs, told the Newsnight programme the other evening that they would not seek finance from the UK or the US? Where will they get their finance? On Monday evening, I asked the Foreign Secretary about the fact that the $130 million appeal for UN humanitarian aid had realised only $30 million. Who has supplied that $30 million?

Mike O'Brien: The NGOs will have to decide how they want to deal with any particular request for money. Some may feel that they want to make requests, and in those circumstances we will discuss such requests with them. Some may decide that they do not want to do so. There is nothing that we can do about that, but we hope that they will become engaged in the relief process.
	On the availability of resources, DFID has made a call on its contingency reserve. We want to ensure that sufficient resources are available to enable humanitarian efforts to be carried out.

Chris McCafferty: Can the Minister clarify the time scale for the necessary resolution at the UN Security Council to restart the oil-for-food programme, given the comments of the UN co-ordinator to the Select Committee that that could take up to four weeks?

Mike O'Brien: As regards the time scale for the initial humanitarian resolution, the objective is that it should be done almost straight away. Provided that we can complete the discussions with the UN, we would hope to be able to do it within a matter of days or a week or so. The wider humanitarian effort may require a little more discussion in the Security Council; we have draft proposals that we hope to discuss with other members of it. That may take a week or two.
	On the oil-for-food programme, we have already worked on plans to ensure that it keeps operating. The basic structure exists for its broad administration, but we will have to ensure that when the coalition forces are in Iraq, and the NGOs follow them up, the necessary administrative structure is in place to ensure that everyone gets the food and other resources that they urgently need.

Peter Lilley: The Minister won the respect of the House when he was sacked for revealing the communications between his old Department and others. He seems to have been reappointed on the condition that he does not repeat the offence or gives the impression that no communication is taking place. Will he now tell the House which Department is co-ordinating this very important humanitarian operation? If it is DFID, why is not the excellent Under-Secretary of State for International Development giving us much more informative answers, as I am sure that she could? If it is not DFID, does that reflect the uncertain status of the Secretary of State for that Department?

Mike O'Brien: The right hon. Gentleman is a former Secretary of State, and I expect something more from him than cheap comments like that. We are dealing with issues of conflict, refugees and ensuring that lives are protected. The cheap comments that he comes out with make his questions barely worth answering, but let me try to do so in any event.
	He asked which Department is co-ordinating the operation. Obviously, DFID is co-ordinating it through other Departments and committees. Cabinet Committees are also dealing with the issue, and DFID is co-ordinating some of the operations between the UN and the various other NGOs that will deal with the post-conflict situation.
	The reason I am answering questions is that I have just come back from Washington, where I discussed the terms of the UN resolutions and the detail of how the post-conflict humanitarian circumstances will be dealt with by the United States and by this country.

Simon Thomas: Does the Minister share the concerns of the civilian NGOs who want to follow any conflict as soon as possible with civilian aid in Iraq? Is he aware that the cost of militarily delivered humanitarian assistance in Afghanistan was $7 for a certain item that could be delivered by civilian humanitarian aid at a cost of 30 cents per item, and that it is therefore important to get the civilian NGOs into Iraq as soon as possible? Does he agree that conflict reconstruction in Iraq will arise from three sourcesthe previous Gulf war, the neglect of Iraq by Saddam Hussein and any destruction that occurs in this conflictand that it would therefore be wrong for the entire revenues of the oil programme in Iraq to be used for that? Can he say a little more about the extra resources that his Government will make available directly to DFID for humanitarian efforts in Iraq not only now, but in future?

Mike O'Brien: We have been clear that the oil money will be put into a trust and will be used for the benefit of the people of Iraq. There is also substantial further American money that is being deployed for humanitarian and aid purposes, as well as the resources I mentioned earlier that will be deployed by the British Government, and we anticipate that other countries will wish to make substantial contributions, as will the United Nations.
	As for the cost, it is true that military costs will be higher than those of NGOs. The problem with Iraq, however, is that although some NGOs have operated there in the past, there are very few of them and they do not operate freely. Furthermore, many of them will withdraw in the next few weeks. Post conflict, therefore, the military will be there first. It is best that they are in a position quickly to deliver the aid that is needed, so they have been resourced to do that. However, as soon as we are able to do so, we will bring in other NGOsthe UN and other organisationsto ensure that aid is deployed, as the hon. Gentleman says, more cheaply, but, more importantly, more effectively.

Hugh Bayley: Will my hon. Friend look at paragraph 25 of the report, which records the UN's estimate that during the Gulf war between 15,000 and 30,000 refugees died from infectious diseases such as measles, diarrhoea, cholera and typhoid? Will the Government ensure that refugee camps have not only sanitation and clean water, but immunisation for refugees as they arrive and health care for those who are ill?

Mike O'Brien: I assure my hon. Friend that there are provisions to deal with the availability of water supplies in any refugee camps that may need to be set up and to ensure, in terms of the military operations that are conducted, that there is as little disruption as possible to proper water supplies so as to minimise the problems that we may face post conflict.
	On immunisation, it is enormously important that if any refugee camps are set up there are effective immunisation programmes to ensure that infectious diseases are not spread within them. We shall certainly put in place the medical and other facilities to ensure that effective immunisation programmes are set up.

Patrick Cormack: Is the hon. Gentleman aware that those of us who gladly gave support to the Prime Minister yesterday, and who admire enormously the national leadership that he is giving, nevertheless attach almost equal importance to the subject that we are discussing? Does he accept that it is absolutely incredible that he should be answering these questions? We are sorry that the Under-Secretary appears to have lost her voice, but it is important that whoever is in charge of these mattersthe Minister said that it is the Secretary of Stateshould enjoy the confidence of this House. One Minister has lost her voice; the other should lose her job.

Mike O'Brien: I have passed on to my hon. Friend the Under-Secretary the hon. Gentleman's sympathy for the loss of her voice. I assure him that it will come back and will be as strong and effective as ever. I am fully aware that the House attaches enormous importanceas do my right hon. Friend the Secretary of State for International Development and Ito the issue of humanitarian aid, and we will make sure that the Government treat it as a very high priority so as to ensure that that aid, and the human rights back-up that is also required, is in place.

Several hon. Members: rose

Mr. Speaker: Order. We must move on.

Points of Order

Caroline Spelman: On a point of order, Mr. Speaker. I want to stress that in asking for the urgent question today we knew that the Secretary of State was on her way elsewhere. I hope that I made that clear. Is it in order, however, for the Department that is the focus of the urgent question to pass on the responsibility for answering to another Department? I have to say that I found all the answers profoundly unsatisfactory. I repeat my request for an urgent statement from the Secretary of State, and I will keep on asking for it until we get it.

Mark Francois: Further to that point of order, Mr. Speaker.

Mr. Speaker: Order. I am going to answer the point of order. It may be, once I have answered it, that the hon. Gentleman will not have to raise anything further.
	It is up to the Government which Minister comes to the Dispatch Box to respond on such matters.

Eric Forth: Further to that point of order, Mr. Speaker. You will have observed, as I have, that the Minister from the Department for International Development, who is in her place, spent almost the entire time briefing the Minister from the Foreign and Commonwealth Office. What puzzles me, no doubt the House, and perhaps even you, Mr. Speaker, is that, if the Minister who obviously knows about this matter is sitting silent, and the Minister who does not seem to know very much about it is attempting to answer questions but is being briefed by the Minister who does, what sort of attitude on the part of the Government does that display to the House and to you, Mr. Speaker? Why do we have to have this musical chairs act when we are engaged in discussing a very serious matter and should be getting proper answers from the proper Departmentthe Secretary of State having apparently fled the country?

Mr. Speaker: I say to the shadow Leader of the House that we must move on to the protected business. The matters that have been raised have nothing to do with the Chair.
	Are there further points of order? I want to move on from the urgent question, as it has run for long enough.

Ann Clwyd: On a point of order, Mr. Speaker. We have heard reports, as yet unconfirmed, that Tariq Aziz has defected to northern Iraq, to territory held by the Kurdistan Democratic Party. If that report is confirmed, it would be useful to have a statement.

Mr. Speaker: I am sure that the appropriate Minister will have heard.

Mike O'Brien: Further to that point of order, Mr. Speaker. We too have heard these rumours. At this point, they have not been confirmed. We are seeking confirmation.

Glenda Jackson: On a point of order, Mr. Speaker.

Mr. Speaker: Is it on another matter?

Glenda Jackson: It is, Mr. Speaker. The Government are advising the citizens of this country to lay in stores including tinned food, bottled water, a torch and blankets, yet there is no further detail as to why they should be laying in such stores. If no Minister has asked to come to make a statement on this matter, I would like your advice, Mr. Speaker, on how best to prise from the Government rather more detail on what is a somewhat bizarre piece of advice.

Mr. Speaker: The hon. Lady is a very experienced Member of Parliament and I would have thought that her first move would be to phone the Minister concerned and ask him.

Glenda Jackson: Which Minister?

Mr. Speaker: I am not inviting her to do so, but she might start at the top and then work her way down.

Patrick Cormack: Further to the point of order that was raised by the hon. Member for Cynon Valley (Ann Clwyd), Mr. Speaker, to which the Minister responded a moment or two ago. May I suggest through you that, if the rumour is confirmed, the Minister be invited to make a definitive statement later today?

Mr. Speaker: The Minister will have heard.

Mike O'Brien: indicated assent.

David Maclean: Further to the point of order that was raised by the hon. Member for Cynon Valley, Mr. Speaker, and further to the Minister's intervention during that point of order. May I suggest to the Minister that, throughout the coming conflict over the next few days, if he does have information that may be of benefit to the House, this side of the House, through the usual channels, will be very willing to facilitate the interruption of business at any sensible and convenient hour, or to stay later than the normal hours, so that the House can be kept fully informed, where appropriate, of information that is not militarily sensitive?

Mike O'Brien: We will try to keep the House informed. We need to be careful about rumours, because rumours often sweep through. The rumourand I want to emphasise that it is no more than a rumour at this stageis from a Bulgarian source. [Interruption.] It is no more than a rumour, but it is that Tariq Aziz may have been killed. There are rumours at the moment but we do not know whether they are true. We will seek to clarify the situation. Once we have clarified the situation, I will be sure to keep hon. Members on the Opposition Benches informed.

Registration of Private Foster Carers and Child Protection

Tim Loughton: I beg to move,
	That leave be given to bring in a Bill to require the registration of private foster carers; to institute procedures for identifying and monitoring children arriving in the United Kingdom unaccompanied by adults with parental responsibility and make provision for their welfare; and to amend the law with regard to joint enterprise when prosecuting carers responsible for the death of children in their care; and for connected purposes.
	My Bill is wide ranging. It deals with three main aspects of child protection, all of which are very topical after a string of child abuse and child murder casesmost prominently, the tragic murder of Victoria Climbi at the hands of her private foster carers, following which there was the comprehensive report by Lord Lamming on the whole horrific series of blunders that led up to the murder. The horrendous circumstances of Victoria Climbi's death should not, however, lead us to overlook the many other tragic murders of children at the hands of their parents or carers.
	It is difficult to comprehend, but, in this country, an average of 79 child homicides happen every yearmostly involving children under the age of five and mostly at the hands of the child's parents or carers. More incredible still is how few murder convictions are subsequently secured. Out of 366 such cases that were investigated by the National Society for the Prevention of Cruelty to Children, only 99 resulted in a conviction, and no further action was taken in a staggering 225 cases. Of the convictions, few were actually for murder if they involved a couple jointly, because of the difficulties of providing joint enterprise evidence and of proving who struck the fatal blow. Consequently, many people escape with the lesser charge of cruelty, as happened in the case of four-year-old John Smith in my constituency. He died from brain injuries after a catalogue of abuse by his foster parents, Simon and Michelle McWilliam. They received a maximum eight-year sentence for cruelty, not murder, as each blamed the other.
	I know that the Government and the Law Commission are sympathetic to changes in the law, although attempts to amend the Criminal Justice Bill in Committee earlier this month were not taken up. My Bill offers a second chance and would place a duty of care on parents if a child was suffering and establish a charge of joint enterprise on parents equally if, when charged with the death of a child, they gave similar accounts of the circumstances leading up to the death that later turned out to be false. In the meantime, the situation could be helped by better guidance from judges to juries on the complicated matter of joint enterprise.
	My second and main subject is the absence of a legal requirement for the registration of commercial private foster carers. Child protection legislation can be traced back to the Infant Life Protection Act 1872, which was produced in the wake of a Select Committee report on private fosteringor baby farming, as it was then known. That report was the response to the case of a Mrs. Walters, who, in 1870, was tried and executed for the murder of several children. That legislation was the first recognition of a public duty in this area. Much more legislation has followed. The Nurseries and Childminding Regulation Act 1948 provided a set of checks on child minders. Registration followed with a 1968 Act. Those Acts have promoted a strong professional culture with training and support benefits for child minders. There were extensive improvements to recognise the paramouncy of children's welfare in the Children Act 1989. In 1993, an inspection of private fostering by the social services inspectorate raised some real concerns about the welfare of children who are cared for in this way. In 1997, the Utting report, which was commissioned by the Government, came down strongly in favour of a system of private foster care registration. The report stated that children in private foster care are
	extremely vulnerable and at very considerable risk of abuse.
	However, Utting's recommendation was not subsequently taken up.
	In 1999, a joint working party on foster care revealed the high potential for abuse and neglect. It urged the regulation of private fostering and a public awareness campaign. Most recently, Lord Lamming has recommended a review of the situation. Through all of this time, we have seen extensive regulations for child minding; care standards for the inspection of care homes and foster agencies; new adoption rights and requirements; hundreds of thousands of people dealing with young people being subjected to checks by the Criminal Records Bureau; and even legislation to clamp down on puppy farming. However, incredibly, people who offer their services as private foster carersoften as complete strangershave no legal compunction to register their services, although local authority registers do exist. For those people, unknown to local social services departments, there can be no guarantee of the quality of care, no guarantee that the foster carer is accessing appropriate training support and benefit, and no control over the number of different placements that the child will experiencewhich, under Quality Protects guidelines, should be no more than three.
	I am sure that the great majority of private foster carers do a good job and pose no threat to their charges. However, we simply do not know. In any case, the Climbi inquiry was the first inquiry into the case of a privately fostered child by any central Government or local government board. We have no idea of the extent of the problem. After all, the Department of Health stopped collecting data on private fostering in 1991 because its figures were so inaccurate.
	It has been estimated that there are between 8,000 and 10,000 private foster carers in this country, mostly for under-five-year-olds from west Africa. However, that is probably only the tip of the iceberg. Since the 1991 regulations, there have been local registers of foster carers but there is no legal penalty for not registering, and many people are ignorant of the requirements. Similarly, local authorities have a duty of care for the general welfare of privately fostered children; but they have to find those children first and even then they have few powers to dismiss poor foster carers. Added to that, surveys and inspections show that the monitoring of private foster arrangements has low priority with many local authorities and, in some cases, it is non-existent.
	It is thus time to make it a legal requirement for private foster carers to notify their activities to a register of private foster carers, with penalties if they fail to do so. It would also be an offence for people to entrust their children to a private foster carer who is not so registered. It is time to expose an underground activity to the reasonable scrutiny of the light of day. There is no guarantee that all private foster carers would register, but the measure should act as a significant incentive, accompanied by local awareness campaigns.
	The definition of private foster care is:
	When a child up to the age of 16 (or 18 if disabled) is placed for more than 28 days in the care of someone who is not a close relative, guardian or someone with parental responsibilities.
	Close relatives are parents, step-parents, siblings, brothers or sisters of a parent, or grandparents.
	The register would not be easy to police; no system can be foolproof. I do not want to play the nanny state and interfere with arrangements for children who are legitimately attending boarding schools or language schools or who are on holiday exchanges and so on. In most cases, there are existing checks on those educational establishments and the families with whom they may place children. It should be possible to establish regulations to exclude what are technically different types of fostering.
	My Bill would set up a national register of private foster carers of children aged under 11, with penalties for non-registration that are similar to those for child-minding registration. The register would be simple and could be run for relatively little cost by an agency, using arrangements similar to those for the adoption register. The registration requirements would be minimal.
	There would be many advantages. The register would be available to birth parents who still wanted to pursue a private foster arrangement. It would enable local authorities to ensure that standards of care were suitable and that appropriate help was offered. A national register would deter private foster carers who had fallen foul of local authority inspections or authorised foster agencies, but who had not committed offences sufficient to be put on the Department of Health 99 list and had simply moved to another area and set up business there. The register would be welcomed by all those involved with children in care in this country, and would provide an added degree of protection for children placed in private foster care, both domestically and from overseas, with minimal intrusion.
	My third and final consideration concerns children who arrive at ports or airports, unaccompanied by adults who are their parents or who have parental responsibility. That is how Victoria Climbi arrived on our shores. That is how many Nigerian girls arrive at Gatwick airport claiming asylum, only for many of them to end up in prostitution at the hands of pimps in northern Italy. That is how many children are being trafficked by unscrupulous individuals and destined for a grim existence; let alone all the many children who are sent by their parents to the UK in the hope of a better future, but largely in ignorance of the care they will receive or the circumstances in which they will be placed.
	My Bill would make provision for better checks on children arriving in the UK unaccompanied by parents, close relatives or those with parental responsibility. Such unaccompanied children would be required to have special written and logged permission from their parents or those with parental responsibility, with information about the length of their stay and who will be responsible for them while they are resident in the UK. Arrangements with schools, language schools and so on would require no further checking but, under the new register, checks would need to be made for children destined to live in commercial private foster care or under other arrangements. Local agencies, such as social services, would be alerted so that the necessary monitoring provisions could be instituted as appropriate.
	Failure to produce permission to travel would warrant investigation by the authorities before the child is able to leave the port of entry, either to be returned home or to live in the UK. Such arrangements would go a long way towards clamping down on child trafficking, the abuse of unaccompanied child asylum seekers and the commercial exploitation of children.
	My Bill is intended to institute only minimal interference and regulation, but the primary purpose of any such changes should be not the benefit of carers but the protection of children. It is to them that we all have a duty of care.
	Question put and agreed to.
	Bill ordered to be brought in by Tim Loughton, Mr. Andrew Lansley, Ms Meg Munn, Kevin Brennan, Miss Julie Kirkbride, Jonathan Shaw, Mr. Julian Brazier, Miss Anne McIntosh, Mr. Jonathan Djanogly, Mr. Robert Walter, Mr. Robert Syms and Mrs. Eleanor Laing.

Registration of Private Foster Carers and Child Protection

Tim Loughton accordingly presented a Bill to require the registration of private foster carers; to institute procedures for identifying and monitoring children arriving in the United Kingdom unaccompanied by adults with parental responsibility and make provision for their welfare; and to amend the law with regard to joint enterprise when prosecuting carers responsible for the death of children in their care; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 4 July, and to be printed [Bill 80].

COMMUNITY CARE (DELAYED DISCHARGES ETC.) BILL (PROGRAMME) (NO. 2)

Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 29 October 2002],
	That the following provisions shall apply to the Community Care (Delayed Discharges Etc.) Bill for the purpose of supplementing the Order of 28th November 2002
	Consideration of Lords Amendments
	1. Proceedings on consideration of Lords Amendments shall be completed at the moment of interruption on the day on which they commence.
	2. Those proceedings shall be taken in the order shown in the first column of the following Table, and each part of those proceedings shall (so far as not previously concluded) be brought to a conclusion at the time shown in the second column.
	
		TABLE
		
			 Lords Amendments Time for conclusion of proceedings 
			 Nos. 1 to 3, 5, 47, 4, 10 to 13, 21, 7, 8 and 39. Three and a half hours before the moment of interruption. 
			 Nos. 6, 9, 14 to 16, 18, 23, 17, 19, 40, 42 and 44 to 46. Two hours before the moment of interruption. 
			 Nos. 24, 25, 22, 26 to 28, 33, 43, 34, 35, 41, 20, 32, 29 to 31 and 36 to 38. The moment of interruption. 
		
	
	Subsequent Stages
	3. Any further Message from the Lords may be considered forthwith without any Question put.
	4. Proceedings on any further Message shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.[Mr. Woolas.]
	Question agreed to.Orders of the Day

Community Care (Delayed Discharges Etc.) Bill

Lords amendments considered.

Clause 1
	  
	Meaning of NHS Body and Qualifying Hospital Patient

Lords amendment: No. 1.

Jacqui Smith: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Speaker: With this we may discuss Lords amendment No. 2 and the Government motion to disagree thereto and Lords amendment No. 3.

Jacqui Smith: In welcoming the Bill back from the other place, I take this opportunity to express my appreciation of the work of my noble Friend Lord Hunt in taking the Bill through the Lords. He was a good and able colleague, who will be missed by me and by many people who are interested in this sector.
	Lords amendments Nos. 1 and 3 are technical amendments, which are necessary to provide clarification that the Bill does not apply to any person who is ordinarily resident outside England and Wales. They do not affect the substance of the Bill in any way, but simply serve to avoid any misunderstanding in the future about the patients to whom the Bill is intended to apply. I therefore hope that hon. Members will join me in supporting them.
	We disagree with the Lords in their amendment No. 2. The amendment would specifically exclude patients with a mental health condition from the Bill's provisions. The intention of the Bill is that payment responsibility should rest with the body that has responsibility for providing for the needs of a patient, to ensure that the patient receives the right care, in the right place and at the right time. It would establish a system of incentives to ensure the appropriate delivery of care.
	The Government's intention is to use the regulations to exclude mental health care from the scope of the Bill, and later to extend the provisions of the Bill to other types of care where there are delays. We have chosen to take a pragmatic approach, as we do not want to overload local partnerships with preparing for implementation across the system.
	It is not justified, however, to prevent the possibility of those provisions being extended to cover mental health. Indeed, the Joint Committee on Human Rights was concerned that the provisions of the Bill should not exclude patients with mental health problems, as that could be seen as discrimination because the nature of the patient's condition was mental rather than physical. However, we will make the decision to extend the scope of the Bill after a full and proper examination of the needs of mental health patients and of incentives in the mental health sector as a whole.
	The Department has received representations from many mental health professionals who are concerned that their patients should be included in these provisions as soon as possible, to benefit from the more timely provision of services that should result. For example, an e-mail from a consultant psychiatrist for older people puts it clearly:
	Many of my patients are waiting months for placement in appropriate long term care; waiting on an acute ward with acutely ill, depressed or confused patients is very detrimental to their health. They are just as disadvantaged as any other older patient which this Bill seeks to benefit.
	I recognise that concern. Surely patients with mental health problems deserve the opportunity to ensure, as the Bill will for other patients, that they receive that care when they need it.
	If the Bill is successfulI am confident that it will bein continuing to reduce patient waits for community care services so that patients can be safely discharged from hospital, I cannot understand how excluding mental health patients from the system can be justified. The right course of action is to monitor the effect of reimbursement on the acute sector and then, if appropriate, make a decision to include the mental health sector in the light of evidence. If we were to exclude that sector now, we would fail to recognise the very important benefits that the Bill could bring, and that could be discriminatory; so I hope that my colleagues and other hon. Members will disagree with the Lords in the said amendment.

Simon Burns: I wish to speak to Lords amendment No. 2. I hope that my right hon. and hon. Friends and others will not share the Government's view that they should disagree with the other place in that amendment, because its purpose is to exclude mental health patients from these provisions. Notwithstanding what the Minister has just said, we believe that there is a separate problem with mental health patients, as opposed to acute patients, partly because of the historic situation in the national health service until about a decade ago.
	I believe thatthis is becoming a bit of a clichmental health was a Cinderella service until about a decade ago, regardless of which Government were in power. If a Governmentagain, regardless of their political complexionneeded to make savings or had financial constraints on health spending for other reasons, it was too easy to sweep a range of services under the carpet, and mental health services suffered most. In addition, there wassadly, there still isa problem with the general attitude of this country's population.
	Some people think that there is something odd or unacceptable about mental health problems, so people suffering from such problems do not receive the same consideration and concern from friends and even family as other patients. That prejudice has continued despite, to be fair, the efforts of this Government and those of John Major's Government to reduce the stigma attached to mental illness and to bolster the health service provision for those with mental illness with genuine increases in funding and focusing attention on improving and enhancing mental health care. There is still, however, a fundamental differencewhether it is right or wrong is another matterbetween mental health patients and acute patients, and the Bill should reflect that fact of life, whether one likes it or not.
	Of course, over-extended stays in psychiatric wards are a problem. For example, a recent survey in acute psychiatric wards, conducted by the Sainsbury Centre for Mental Health, concluded that hospital care was non-therapeutic, but there are times when hospital admissions cannot be avoided. For example, when patients are so ill that they are incapable of looking after themselves, hospitals provide the only appropriate care for them. However, mental health care is in many ways very different from acute care, so different approaches are needed.
	Given those unique mental health considerations, if legal duties are imposed under the Bill to compel one part of the sector, in effect, to penalise the others, that could put at risk especially vulnerable patients suffering from mental health problems. In addition, there is a shortage of capacity in hospitals, other supported accommodation, rehabilitation services and 24-hour staffed beds in inner cities. As a result, to require local authorities to provide care quickly in those circumstances is unrealistic and unfair, and it could be dangerous in certain conditions.

Hilton Dawson: Instead of trying to introduce some, frankly spurious, distinctions between mental health and other aspects of the health service, will the hon. Gentleman direct his remarks to the question of the right patients? Do not people with mental health problems have exactly the same right as anyone else to live in the community and receive provision there?

Simon Burns: I find the hon. Gentleman's intervention slightly contradictory and complex, but I agree with the last part of what he says. No one wants people to be kept in hospital when they do not need to be there, and all of us want each patient to receive the most appropriate carewhether, in the case of the elderly, in their own homes with a domiciliary care package, or in residential care homes. We would agree on that. With respect to the hon. Gentleman, particularly given some of his statements in recent days, I resent his use of the word spurious because the argument is not spurious, and I hope that the hon. Member for Wakefield (Mr. Hinchliffe), who is the Chairman of the Select Committee on Health, will back me up.

David Hinchliffe: It is not exactly a secret that I am not the Bill's biggest fan, but I am trying to understand how Lords amendment No. 2 would work in practice, and I have not been assisted so far by the contribution of the hon. Gentleman who speaks from the Opposition Front Bench. What is meant by the phrase a person receiving mental health services? That seems to be such a wide-ranging definition, and it could include huge numbers of people who are on antidepressants from a general practitioner. Is the hon. Gentleman specifically focusing on individuals in psychiatric beds in acute hospitals? Is that the purpose of his argument?

Simon Burns: I am grateful to the hon. Gentleman for that intervention. I apologise if I am being obscure in certain areas, but, yes, the fundamental basis of my argument is that I believethis is the intention of Lords amendment No. 2that those people who are, in effect, defined as receiving treatment in hospital psychiatric beds should be exempt from the Bill. The bottom line is that I do not want the pressure that the Bill will put on hospital discharges to be put on those patients because of the nature of their illness and treatment, and the Bill should recognise the difference between mental health treatment and acute treatment. I know what the hon. Gentleman said, but it is interesting that the Minister in the other place, the late Lord Hunt

Jim Fitzpatrick: He is not dead.

Simon Burns: The Whip is absolutely right. Lord Hunt is not dead, but he is politically dead to such an extent that the Deputy Prime Minister did not recognise that he was a human being or that he had been a member of the Administration, despite the fact that he had been for almost six years. He is politically dead, so the word late was probably justified in that context.

Glenda Jackson: My confusion about the hon. Gentleman's proposal arises because he talks in a broad and categorical way about patients who are in beds in psychiatric hospitals, but even that does not bring the definition down to a level that I find comprehensible. People who suffer from mental illnesses may need a bed in a secure psychiatric hospital for a comparatively short time, but others will need such a bed for much longer. There are as many variations among the extreme episodes endured by people who suffer from mental illnesses as there are in any other field of medicine. The proposal is simply not clear.

Simon Burns: The hon. Lady is entitled to her view. Her point that the time spent in a hospital bed by an individual suffering from mental health or acute health problems will vary depending on individual circumstances is right. The point that I am trying to make is that the situation is different for mental health, and we do not want to impede the treatment and future appropriate care of individuals suffering from mental health by putting them under the umbrella of the Bill and placing additional pressures on them.

Andy Burnham: Will the hon. Gentleman give way?

Simon Burns: I shall not, because I want to make progress.
	The answer is to exclude mental health patients from the Bill in the same way as other groups of people will be excluded from its ambit, although the Government have the power to include them if they are so minded. Excluding mental health patients is the right way to proceed because of the nature of mental illness and its historic position in the NHS until about a decade ago. The group could be included in the future, but it should not be included at the moment. That is why I hope that the House will agree with the Lords amendment and disagree with the Government's motion.

David Hinchliffe: I shall simply respond to the hon. Gentleman's comments. I listened carefully as he supported the Lords amendment, but his arguments do not seem to relate to its wording. His comments were very specific. He clearly implied that he was focusing on the circumstances of individuals who are in acute psychiatric beds andto use his wordssuffering from mental health. We all have mental health, although we do not necessarily suffer from it. The phrase is suffering from mental illness.
	The amendment is more wide ranging than the specific matter on which the hon. Gentleman focused. Despite my personal opposition to the Bill, I cannot understand how the Government could honestly accept the amendment, because it is badly drafted and so wide ranging that it could cover any number of individuals, which I do not believe is the hon. Gentleman's intention.
	Other Lords amendments would improve the Bill, although I am not necessarily convinced that they would be a positive step toward addressing delayed discharges. Indeed, the Government might concede that on occasions. The hon. Gentleman's arguments are extremely thin and the Government could not genuinely accept such a wide-ranging amendment.

Hilton Dawson: I shall be much more generous to the hon. Member for West Chelmsford (Mr. Burns) than my esteemed and hon. Friend the Member for Wakefield (Mr. Hinchliffe), because the hon. Gentleman made a good attempt at proposing something that is basically unacceptable. I do not believe that his remarks showed a total commitment to the amendment.
	The Lords amendment is appalling and should be dismissed out of hand. We should question what the other place was doing when it was tabled. It would be quite wrong specifically to exclude mental health services from the range of services that will be includedbefore very long, I hopein the provisions of this first-class Bill. I recently visited Ridge Lea hospital, which is my local hospital in Lancaster, and I met people who had been living on the locked Lonsdale ward for many years. The patients and the people who care for them expressed enormous concerns about the difficulties entailed in assisting patients to move on to appropriate community services. Difficulties are encountered when liaising with social security services. It is extraordinarily difficult to ensure that the patients have appropriate places to live in the community and that appropriate support services are available.
	Some of those people lived in locked circumstances with restricted liberty. It is outrageous, and a matter of enormous worry, that people live in such circumstances for longer than their acute mental health needs require. If appropriate provisions were available in the community, they could move there with their liberties assured. That is a fundamental human rights issue. I have no doubt that the Bill is not a universal panacea. We need considerable investment in, and new legislation for, mental health services. However, the provisions will be an enormous help for such people by ensuring that agencies are made well aware of the need to work closely together to ensure that services are available.
	I am slightly disappointed that mental health will not be one of the services to which the provisions will apply immediately. I urge hon. Members to reject the amendment, but I also urge my hon. Friend the Minister to assure me that the Government will move quickly to ensure that mental health services are included.

Glenda Jackson: I also have concerns about the amendment. The Opposition say that mental illness services are a Cinderella service and that they are anxious that they are improved. I am perfectly prepared to accept that that is an honourable and justifiable position to take. The Government have done much to bring services for mentally ill patients out of the shadows and into the light, but I am sure that they would not want anyone to believe that the services are in full sunshine as yet. However, great improvements have been made.
	I am sure that, with the best will in the world, the Opposition want to ensure that mentally ill people receive treatment but, as my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson) pointed out, their amendment would lead to seemingly permanent incarceration behind locked doors. Such a provision would act as an active deterrent to improving mental health services for everyone.
	I have some questions for my hon. Friend the Minister. I have concerns about the definition of services that will be provided only to someone who is normallyif that is the correct wordresident in England and Wales. My concerns stem from a case in my constituency in which the mother of a family in my constituency was resident in Northern Ireland. She visited the family in my constituency, but was taken ill. She received excellent treatment from the national health service, but the family then decided that, because she lived alone in Northern Ireland, she should come to live with them. Does the provision mean that my constituents' mother will be excluded from a proper care package that is put in place by my local authority? What does resident mean in that context?
	When my constituents raised this case, I was concerned because people from all over the world reside in my constituency. They have the right to live in this country and they have lived here for a considerable time. They pay their taxes and are not a drain on the state. If one of their elderly relatives should visit and the same situation were replicated, would that mean that the citizens of the United Kingdom whose parents come from a country other than England or Wales would not receive proper care or would not be able to patch into the national health services that are open to the rest of the United Kingdom's citizens? Will my hon. Friend clarify the position?

Patsy Calton: I wish to support amendment No. 2, and I shall argue that it deserves particular consideration.
	I accept the Minister's argument that no one in the House wishes to stigmatise mental health patients or to treat them as a completely separate group. However, we are considering an imperfect Bill that deals with particularly vulnerable groups of people, such as mental health patients, who, on occasions, are not able to articulate their own needs. Therefore, particular care should be taken when they are discharged from hospital.
	I hope that the amendment will remain in the Bill. Mentally ill people and other vulnerable groups should not be among the patients for whom a charge is made.

Meg Munn: Surely the point about the process is that the patient is deemed able to be discharged at the appropriate time. Therefore, the decision that it is right for the patient to move on to more appropriate care is taken by the health care professionals who are charged with taking care of the patient's mental health. By agreeing to the amendment, we would be going against the advice of the professionals who have that responsibility.

Patsy Calton: I thank the hon. Lady for that intervention. I am interested to hear that she perceives this to be a very much one-sided decision process. The reason Opposition Members are concerned about the Bill and its references to vulnerable patients is that it will speed up the process by which particularly vulnerable people are removed to the exclusion of assistance from other carers and expert advocates.

Simon Burns: Does the hon. Lady agree that the flaw in the logic of the intervention of the hon. Member for Sheffield, Heeley (Ms Munn) is that, at the moment, the Government have exempted other groups from the Bill even though they may bring those groups within the Bill's ambit at a later stage?

Patsy Calton: A further flaw results from the fact that, as the Minister said, the Government have taken a pragmatic approach to mental health patients. For the time being anyway, they have exempted them. If the charge of stigmatisation applies, it applies to that pragmatic approach.
	I am concerned that because of the different procedures for mental health and acute discharges and because of the differences in working across health and social services, the onward journey of services users will not be facilitated by the Bill. Under the draft regulations, the local authority would not be made liable if the patient was waiting for an NHS or another community service, such as psychiatric or mental health care provision, after the care assessment, but found that service unavailable because of the lack of social care provision. The Minister and the Government cannot have it all ways. If it is now right to exempt mental health patients, it must be right at a later date unless we can be absolutely sure that all the necessary provision is available.

David Hinchliffe: My worry is that these debates increasingly tend to consider segments of care. We put people into compartments, and that is where they remain. I intervened on the hon. Member for West Chelmsford (Mr. Burns) because I believe the Lords amendment to be flawed. For example, an elderly patient could be initially admitted to a psychiatric bed before being put into an elderly care bed in an acute hospital as they get ready for discharge. Is that person a mental health patient or not?

Meg Munn: They might have Alzheimer's.

David Hinchliffe: As my hon. Friend suggests, Alzheimer's and a whole range of conditions lead to people being moved from an acute psychiatric environment in a general hospital to a psychogeriatric situation or to an acute ward. At what stage is someone a mental health patient? It is inconceivable that anyone could genuinely operate the Bill if it contained this amendment.

Patsy Calton: I thank the hon. Gentleman for that point, but the Minister has accepted that there is a problem. She has decided that there will be an exemption for mental health services and I presume that she, like the rest of us, has read the relevant section of the amendment. The arguments that have been made could be given credibility, but it would not take much more precision for the amendment to make it clear in line 10 of clause 1 that those receiving mental health services are those
	accommodated at
	(a) a health service hospital; or
	(b) an independent hospital in pursuance of arrangements made by an NHS body.
	The definitions already exist, and it would not need much further clarification to specify which group of particularly vulnerable patients would be affected. Again, I would add other groups of vulnerable patientsthose who are not able to articulate their needs and who would require additional support in the arrangements for their discharge.
	The Government's national services framework for mental health identifies the lack of capacity in community mental health services, not inefficiencies in social services departments, as the key cause of delayed discharges for psychiatric patients. That will not disappear just because the Bill causes fines to be levied. There will be a tendency to rush assessments of psychiatric patients' fitness for discharge, which entails a complex package of considerations. Patients must be assessed in terms of whether they will self-harm, whether they are a risk to others, and whether they will have appropriate accommodation. It is rare that that can be worked through in a three-day period, even if all the various services are in place.
	There is no provision in the Bill for specialist advocates and for carers to take part in the discharge planning process. There is a risk that pressure to reduce prolonged hospital admissions will concentrate resources on the acute sector at the expense of community care provision. Hard-pressed councils will tend to divert resources into services that avoid penalties, instead of the longer-term preventive work that would reduce the need for acute admissions. There is a further danger that patients discharged earlier than they should be will be given inappropriate medication to control symptoms, rather than a range of therapeutic interventions, because of inappropriate accommodation and a lack of essential support services.
	There is a basic flaw in the Government's argument that they need to make interim provision now, but are not prepared to write that into the Bill for the longer term for particularly vulnerable groups of patients.

Nigel Waterson: I shall contribute briefly, as some of the related issues will arise more naturally later in the Bill's consideration today. There were two major errors in the approach adopted by Members on the Government Benches. One was a gross caricature of what their lordships were trying to achieve by the amendment. The other was the notion that the Bill would be of unalloyed benefit to the average patient. It is precisely because the Bill still is not patient centred that the issue arises.
	The most powerful argument to be deployed in favour of the exclusion, as the hon. Member for Cheadle (Mrs. Calton) said, is the extent to which the concerns of patients and their carers are taken into account. Perhaps it is a matter of first thoughts are best, which is clearly the Government's view at present. At an earlier stage of the Bill's progress, we had some very good briefing from organisations such as the Alzheimer's Society about patients suffering from dementia and more specifically Alzheimer's, and so on. Surely patients with mental health problems, particularly severe mental health problems, will be the most vulnerable category.
	Even if there are proper arrangements for the discharge of such patients and proper consultationwe shall deal with that in more detail laterwill they be able to express a view, let alone an informed view? Will the views of their carers be taken into account on their behalf? For that central reason, the official Opposition have always opposed the Bill. There are many reasons for opposing itnot least, the fact that it will not workbut the most human reason for opposing it is that it ignores the needs and wishes of individual patients. That is true in spades in respect of those with mental health problems. That is the overwhelming argument for the amendment.
	I shall not dwell on the point as we have a great deal of progress to make. I commend my hon. Friend the Member for West Chelmsford (Mr. Burns), who was right to argue that we should support the Lords amendment.

Jacqui Smith: I shall begin by responding to the question from my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson) with respect to amendments Nos. 1 and 3 and the case that she described. Obviously, I do not know the details of the case, but the principle of defining ordinary residence is intended to make it clear which authorities are responsible for the necessary community care provision. The case does not have to come within the ambit of the Bill for social services to have that responsibility. Anybody who establishes ordinary residence will be within the provisions of the Bill. That is established on the facts of the case, and can sometimes be established virtually immediately. Although that is not very clear, the answer probably is that it depends. There would not be an automatic bar against somebody who had come from abroad.
	The main point of contention was Lords amendment No. 2. Let us be clear what the Lords are proposing. It is not that there might be particular issues that make the way in which we respond to patients with mental health problems different from the way in which we respond to other patients in acute care. It is that in perpetuity we should exclude from any benefits that might come from the Bill those people with mental health problems.
	I agree with the hon. Member for West Chelmsford (Mr. Burns) that during the 1980s and 1990s our mental health services were underfunded and poor.

Simon Burns: I am saddened that the Minister is taking that tack. Given of the importance of the issue of mental health, I deliberately tried not to make my comments party political. I said, and it is a recognised fact, that over the past decade, under the last Conservative Government and under this Government, there has been a greater concentration of attention on mental health and inputting of resources for it. It saddens me if the Minister is trying to make political points, saying that the Conservatives did nothing and the present Government have done everything.

Jacqui Smith: The hon. Gentleman can stand or fall on the record of the Government of which he was a member. The first national service framework introduced by the Labour Government tackled the issue of mental health services, in particular linking considerable new investment to attempts to find new ways of addressing some of the problems identified by the hon. Member for Cheadle (Mrs. Calton) in relation to capacity, and to ensuring that services are available in the community to address the needs of people with mental health problems who would be better cared for in the community.
	With the development of assertive outreach teams, crisis resolution teams and early intervention teams, we see that they have an impact on the number of people who need to be admitted or to stay for longer periods in inpatient provision. It is right that we need to expand capacity and reform the way in which we offer mental health services, to make sure that provision in the community is available. Despite improved investment40 million worth of capital over this year and last yearand guidance leading to improved acute inpatient mental health services, there are people for whom inpatient mental health care is not appropriate and who do not want it.
	I find it hard to understand why the Lords and the Opposition, in their support for the amendment, believe that we should for ever exclude mental health patients from the benefits of the legislation. Although I was shocked to hear that my hon. Friend the Member for Wakefield (Mr. Hinchliffe) is not the biggest fan of the Bill in the House, both he and my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson), who, as a fan of the Bill, pressed me to bring mental health within the ambit of the Bill more quickly, recognise the illogicality of for ever putting mental health outside the legislation.
	The hon. Member for West Chelmsford also made the point that those with mental health problems have suffered in the past from stigma, which has affected services. I agree, but I fail to see how ensuring that it would never be possible for those with mental health problems to come within the Bill's ambit helps to tackle that stigma. It does not.
	I do not dispute that different circumstances will apply to people with mental health problems. Of course they will, which is why we have taken the decision that the first group that we should address through the legislation are those in acute hospital care. Different considerations will apply to how we bring in those with mental health problems. As I suggested earlier, we will decide whether to extend the Bill's scope after a full and proper examination of the needs of mental health patients and the incentives in the mental health sector.
	For example, we would want to consider whether, as happens in Sweden, the level of reimbursement or the minimum compliance period should be altered to reflect any additional difficulties that might arise when assessing mental health patients or putting services in place. We would want to recognise that quite oftenfor example, housing services are important to those with mental health problems.
	It is not beyond the wit of the House to ensure that we would be able to recognise those specific circumstances in the future and to design the system to take those on board, and to ensure that those with mental health problems have the opportunity, when it is successful, to benefit from the Bill.
	Lord's amendment No. 2 would ensure that that was never possible and I hope that, on that basis, hon. Members will disagree with it.
	Lords amendment agreed to.
	Lords amendment: No. 2.

Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 320, Noes 178.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment No. 3 agreed to.

Clause 2
	  
	Notice of Patient's Possible Need for Community Care Services

Lords amendment: No. 5, in page 2, line 5, after hospital insert after 1st April 2004.

Jacqui Smith: I beg to move, That this House disagrees with the Lords in the said amendment.

Madam Deputy Speaker: With this it will be convenient to discuss Lords amendment No. 47 and the Government motion to disagree.

Jacqui Smith: Lords amendment No. 5 would delay for a year until April 2004 the implementation of the policy outlined in the Bill. When we announced the policy in April 2002, we were keen to implement it by April this year so that older people could benefit as quickly as possible from the improvements in services and procedures that we firmly believe the Bill will bring. They include: focus on the individual, and ensuring that people get the right care at the right time and in the right place; the introduction of incentives to invest in alternatives in the community so that older people are not trapped in hospital when they would be better treated outside; and a clear framework for partnership between health and social care locally.
	We know from the implementation team that we have established that many areas have made significant achievements since we announced the policies. The Bill has led to an unprecedented wave of activity around delayed discharge with local authority and NHS partners discussing shared problems and finding common solutions. Several areas have initiated reviews of whole systems to consider discharge processes and community service capacity so that they are well prepared for reimbursement.
	Other areas have planned staff increases or co-location to speed up assessment and improve discharge planning. The Bill can therefore be considered a success already because people know that if they do not make efforts to improve discharge procedures and put services in place, they cannot benefit from the extra funding that we are transferring from the NHS. They will have to reimburse the NHS.

Simon Burns: Before the Minister embarks on a spinning fantasy, will she clarify the reason for her use in Committee and now of words such as incentives, bonuses and improvements, when the Secretary of State describes the penalties under the Bill as fines? Indeed, that is what they are.

Jacqui Smith: Despite having been involved with the Bill for a long time, the hon. Gentleman fails to understand the principle that payment follows responsibility. His failure to understand is not my fault. When responsibility for providing services based on the individual's needs shifts from the NHS to social care, so should responsibility for payment.
	The Bill can already be considered a success and we are worried that amendment No. 5 in particular puts that at risk. One social services manager stated that in the past five years he had never witnessed so much commitment to reducing delays in the NHS and social care. That is not an isolated remark. People who attended a recent conference, which our change agents team ran, stated that, far from wrecking partnershipConservative Members have sometimes alleged thatthe pressure to improve discharge that the Bill generates led staff from the NHS and social services to discuss together, sometimes for the first time, plans to reduce delays in their local hospitals.
	There is a genuine risk that the benefits of that concentrated effort will be lost.

John Bercow: I fear that the Minister risks creating a pervasive cynicism about the Billeven more pervasive than that that has existed hithertounless she responds properly to the point of my hon. Friend the Member for West Chelmsford (Mr. Burns). If people incur a financial cost for doing something that they should not, or for failing to do something that they should, can the Minister think of a shorter or more accurate term for what they face than fine?

Jacqui Smith: A fine implies that someone is not supposed to be doing something. It is strange that the hon. Gentleman does not realise that we are considering putting right a position in which all the incentives in the system are for leaving people in hospital over a longer period because the NHS effectively pays for the needs of largely older people, responsibility for which should rest with social services departments.
	If the hon. Gentleman wants to argue for cost-shunting and shifting responsibility, he should do so. The Bill aims to put matters right.

John Bercow: If the Minister will allow me, I will exercise my discretion over the language that I deploy. I would not settle for the rather down-market lexicon that she has in mind for me. If she will not use the word fine, why does the Secretary of State continue to do that regularly?

Jacqui Smith: Perhaps the hon. Gentleman should ask the Secretary of State. My right hon. Friend and I share an understanding that at present[Laughter.] We can laugh and banter about words, but Conservative Members should be ashamed of the underlying reason for the measure. In 1997, 6,800 people were inappropriately delayed in hospital. Our investment and reforms have reduced that number.

Simon Burns: It went up.

Jacqui Smith: I should be interested to know when that happened. There is a significant reduction in the number of delayed discharges that we inherited from the previous Government. Investment and some top-down management have brought that about. We have argued that such a system is not sustainable. We need to ensure that the system includes incentives for the considerable extra investment in local authorities to be spent on alternatives that provide that older people can get out of hospital when necessary. The Bill will achieve that. As I said earlier, to some extent it already ensures that that happens. It gives an impetus to the joint working that we need and the focus on the needs of individuals when they are ready to be discharged from hospital.
	Accepting the amendments will convey the message that the work can be put on hold for a year. The impetus that has built up will be wasted and a continued and sustained reduction in waiting times for discharge will be delayed.
	We have listened to the anxieties of the NHS, local government, the voluntary sector and responsible hon. Members about the speed of implementation and the need for time for new investment in services to bear fruit. The Government have therefore proposed delaying implementation for six months until October 2003. As Lord Morris said in another place:
	The benefits of this Bill are urgently needed and I believe it is not too late to avoid delaying their delivery . . . There is still time for consensus to be reached on this Bill and those it seeks to help deserve no less.[Official Report, House of Lords, 17 March 2003; Vol. 646, c. 19.]

Nigel Waterson: Will the Minister explain to a simple soul like me why it makes things better for the people who have to implement the measure in the real world to introduce it half way through a financial year? Is that sensible? What sort of chaos will that produce in the system?

Jacqui Smith: We would have preferred to introduce the measure in April but we listened to what people in the real world said about their worries. [Hon. Members: Lords.] Whether hon. Members in another place are the people in the real world is questionable, but we listened to people who operate in the real world and we shall ensure, through the delay in implementation, that the considerable extra investment from April 200304 makes the necessary impact without delaying, to the detriment of largely older people, the incentives that the Bill establishes and the action that it has prompted. Those older people will benefit from the provisions and already benefit from the reduction in delayed discharge that the prospect of action has brought about. I do not understand what can be gained from delaying implementation for a year. There is something to lose from that.

Paul Burstow: The Minister has been telling us that the Government have been listening to real people outside this place. Will she comment on why the Government chose to ignore their own consultation results, which showed that primary care trusts, social services departments and voluntary organisations of all sorts told the Government that they wanted a delay of at least a year, and to see implementation no earlier than 1 April 2004?

Jacqui Smith: As I was explaining, we listen not only to those who provide the services, but to the people who need them. They are the older people who, in too large numbers, are being trapped in hospital when they would be better off being treated outside. We believe that the Bill will make a difference to those older people, and that is why we are keen to ensure that it is implemented as soon as possible. Of course we need to listen to the people who provide the services, but thoselargely older peoplewho are being delayed in hospital when it would be more appropriate to treat them outside are at the heart of the Bill and of our concerns.

George Young: If it really is the view of elderly people that the Government should proceed as she has just outlined, why has Age Concern written to every Member of Parliament totally disagreeing with her?

Jacqui Smith: Various groups have taken various positions on this, but I reiterate my view that the Bill is about ensuring that those older people who are currently not getting the deal that they deserve can get a better deal. That is why I do not believe that we have anything to gain from delaying implementation for a whole year. Indeed, as I was saying, we have something to lose. The Secretary of State announced on Second Reading, having listened to the concerns of peopleparticularly those in local authorities who had the responsibility of providing those alternatives in relation to community carethat, in addition to the doubling of the real rate of increase of social services funding, we would also make a transfer from the NHS to social services budgets. If implementation were delayed for a full year, councils would not receive any additional funding in 200304. If it were delayed for six months, and councils received 50 million for that period, they could invest that money during the first part of the year and be able to invest in the staff or services that they needed, in order to avoid reimbursement charges when the scheme is implemented.

Paul Burstow: Will the Minister share with the House the conclusions that the Government had reached about how they would have distributed the 100 million? Would it have been targeted at those authorities that were doing least well in facilitating discharges from hospital, or those that were being the most effective? What decisions had the Government taken on that?

Jacqui Smith: Depending on the progress of the Bill, we hope to be able to issue for consultation our decisions on how that would happen. The whole point of the investment is that it should facilitate the necessities contained in the legislation. The hon. Gentleman makes an important point about one of the disadvantages of the considerable investmentin the form of the building care capacity grantthat has been distributed to local authorities during 200102 and 200203. We took the decisionrightly, I believeto focus that investment on particular hot-spot authorities. That was characterised by some local authoritieswrongly, in my viewas rewarding failure, or rewarding those authorities that had not properly tackled the problems of delayed discharge. That bears heavily on our consideration of howgiven the successful passage of the Billwe should distribute the money that is being transferred from the NHS. That will be part of our consideration.

John Bercow: I am extremely grateful to the hon. Lady for giving way. She knows the high esteem in which I hold her, but I am bound to say that she has not persuaded me, she has clearly not persuaded the House and it seems uncertain whether she has yet managed to persuade herself of this argument. How many individuals or organisations have written to her to express their opposition to the idea of an implementation date of April 2004? She said that there was a miscellany of different opinions: how many, and who?

Jacqui Smith: Nobody has written to us to oppose an implementation date of April 2004. Having said that, nobodyso far as I am awarehas written to us to oppose an implementation date of October 2003 either. People recognise that the Government have proposed a sensible delay of six months, which would maintain progress rather than stymieing it and kicking it into the long grassas Conservative Members want to doto the detriment of the older people who will benefit from this legislation. We must maintain the momentum, so as to build on the good progress that has been made. If we do not, the older people who are trapped in acute beds will continue to suffer.
	Conservative Members have attempted to introduce a variety of ways of wrecking this legislation, aided by their colleagues in another place. The first was to delay the implementation. The second is represented by amendment No. 47, on which I also urge my colleagues to disagree with the Lords. It is effectively a sunset clause, under which the part of the Bill that puts in place the necessary incentives would cease to have effect after five years. This is an entirely inappropriate use of a sunset clause. They are generally used only in Acts that are passed because of national emergencies or are restrictive of civil liberties. Clearly this is not such a Bill. It is, however, a Bill that the Opposition are trying to limit in every way that they can, by delaying the start and limiting its life.
	The argument for this amendment in the other place appeared to be that, because the provisions in the Bill would make a difference, it was necessary to limit their life. Certainly under this Government, the majority of Billsin fact, all the Bills that we introducecontain elements of policy that are new, because they are intended to bring improvement and changes. Of course, all policies should be evaluated and monitoredhow else can the Government ensure that they are successful, and improve them if necessary? However, we already have reliable and well-established procedures and monitoring systems in place to monitor the impact of particular policies.
	In the unlikely event that the Bill does not work in the way that we want it to, we would want to act well before the end of five years. If, on the other hand, as I expect, it drives action on delayed discharges to the point at which hardly any charges will be changing hands at the end of the five-year period, why do we need a sunset clause? Although I suspect that the good practice around planning and assessment underpinned by the Bill would continue, with or without legislation, there would be little additional activity moving funding around. However, one would not want to repeal the Act, since the possibility of charging would remain to ensure that performance on delays did not drift again. As we have heard in the interventions that have been made today, the two amendments are clearly about wrecking and limiting the effects of the Bill. On that basis, I hope that hon. Members will disagree with the Lords.

Simon Burns: May I say from the outset that the Conservatives would like two separate votes on Lords amendments Nos. 5 and 47 at the appropriate time?
	However loveable the Minister might be, one has to admire her sense of humour and her nerve in trying to convince the House about certain issues today. I want to deal briefly with two of them. One is the ongoing battle over the question of fines. To her credit, the Minister has found every word in the thesaurus to try to describe the main thrust of the Bill, except the one word that describes it completely. That word is fines. It is to the Minister's lasting annoyance that her Secretary of State

Hilton Dawson: Will the hon. Gentleman give way?

Simon Burns: No, I will not.
	It is to the Minister's lasting annoyance that her Secretary of State caught her out in his statement after the Budget, when he described his own legislation as fines. Finally, on Report, the Minister herself had the honesty to use the F-word.

Hilton Dawson: Will the hon. Gentleman give way?

Simon Burns: I will, although I am slightly surprised that the hon. Gentleman has spoken as he has. I, too, read Ceefax a few days ago, when he announced to the world in bold terms that because of the Government's policy on Iraq he would not support the Governmenthis Governmentin any Divisions on any matter.

Hilton Dawson: That just goes to show that you should not believe all you read in the press. I am proud to support the Government on this, and on many other aspects of their legislative programme.
	As the hon. Gentleman may recall, we have been around the block before. Will he put himself in the position of a nursing home owner looking after a person who need not remain in the home because his or her needs have changed, who is faced with all the costs of having to care for that person? Is not the use of the word fines entirely misplaced? We are talking about a charge for services. When the hon. Gentleman next goes to a hotel, will he expect to pay, or will he complain to the proprietor that he has been fined?

Simon Burns: I know that there will be a reshuffle shortly because of losses on the Government Front Bench, but I must tell the hon. Gentleman that regardless of whether I believe what I read in the press, the press know what he said. I do not want to disappoint him, but I think that as a result of what he said he will not be considered by the Whip who is currently on duty, or by her colleagues, in the forthcoming reshuffle. As for his narrow point on fines, fines is his own Secretary of State's terminology for what the Government are doing. By all means let the hon. Gentleman be a help to the Government from the Back Benches, but let him at least be consistent with his Secretary of State.
	Let me deal briefly with a point of fact. The Minister challenged my hon. Friend the Member for Woodspring (Dr. Fox) about the number of detailed discharges, saying that when my Government left power in May 1997 the figure was just over 6,000 and that since her Government came to power the figure had always been lower and falling. I remind the Ministerfor I too have the factsthat in 200102, four years almost to the day after this Government came to power, the figure was 6,361, and that in the second quarter it had risen to 7,065. She really must not try to confuse the House with spin that is not based on factual reality.

Jacqui Smith: Does the hon. Gentleman accept that the number of people aged 75 and over whose discharges have been delayed was 3,502 in December 2002? Is that figure not less than half the 6,985 that the Government inherited?

Simon Burns: On the basis of parliamentary written answers I have received from the Minister, I accept that the figures have dropped. There is no secret about that. It is, however, bogus codswallop for the Minister to claim, as she did in her speech, that the result was achieved through the success of a Bill that has not even become lawalthough we are now used to new Labour, new spin.
	The Lords amendments are at the nub of why my colleagues and I, along with many others, oppose this nasty piece of legislation. As I am sure you know, Madam Deputy Speaker, success has many fathers and failure is an orphan. One could list the examples, but as was pointed out by my hon. Friend the Member for Buckingham (Mr. Bercow) and my right hon. Friend the Member for North-West Hampshire (Sir George Young), in the real world in which people look after the elderly in hospital, care homes or their own homes on a daily basis there are no friends for the Bill: it is very much an orphan. Its only supporters are the Minister, her boss and her Back Bencherswith notable exceptions. The wise Chairman of the Select Committee does not support it, along with many other Labour Members.
	Those Members do not support the Bill because it is wrong in its intent to introduce a system of fines that will do incalculable damage to the tremendous progress that has been made over the past decade or so in getting the NHS and local authorities to work together in the whole area of care for the elderly and discharge from hospital. As has been said by many local authorities and by the Local Government Associationled by Sir Jeremy Beecham, a Labour councillor I believeit will damage, perhaps destroy, those working relationships. It will also set the NHS against social services departments. There are better ways of legislating. Moreover, the proposals are unfair. As we all knowexcept, of course, the Minister, who is in constant denial because this is not good news for the Governmentmore than 60,000 care home beds have been lost over the past six years.

David Hinchliffe: The hon. Gentleman knows only too well that that figure, which he keeps parroting, is completely wrong. He knows that the Health Committee, of which he is a member, came up with a figure that, although it did not accord with the Government's figure, certainly did not accord with the Tories' 50,000 figure, which has now risen to 60,000. I respect the hon. Gentleman, who does a good job on the Committee, but he must accept that sometimes we come up with the facts rather than the fiction that he has just presented.

Simon Burns: I respect the hon. Gentleman too. We have a mutual admiration society. If he returns to the relevant papers, however, he will be reminded that we asked the Select Committee to look into the matter and try to find a solution. The Committee said that both figures were right: my figure and the figure of about 19,000 that the Government gave about 18 months ago. The papers go on to say, though, that the Government's figure excludes the number of beds lost in the local authority sector. If the local authority figures are added to the private sector figures, we reach the figure that I have given.

Hilton Dawson: Will the hon. Gentleman give way?

Simon Burns: No, because this is a timed debate and I want to make progress. Along with Lang and Buisson, an independent body, I believe that my figure is correct.
	The fines will put pressure on social services departments to bring about inappropriate and premature discharge of patients from hospitals. Alreadyalthough, interestingly, the Minister did not mention thisthe rate of readmission of over-75s has increased dramatically in the last few years. Let me give the Minister the figures. There were 12,165 readmissions within seven days of discharge in the second quarter of 200102; the number had risen to 13,813 by the third quarter of 200203. That is an increase from 2.9 to 3.3 per cent. Similarly, emergency readmission rates for up to 28 days have risen from 2.9 to 4.9 per cent. By putting unfair financial penalties on the system, patients will be discharged from hospital prematurely, and will perhaps not receive the most appropriate care. As the figures suggest, the result will be unacceptable and unfair readmittance for those patients.
	I believe that we must seek to bring down the level of delayed discharges. Everyone in this House accepts that having people in hospital who should not be there, and at a considerably greater expense than if they were out of hospital, is an utter waste of money; where we disagree is on the solution to the problem. To bring in a simplistic policy that sets local authority against the health service and vice versa, and which can lead to inappropriate and hasty discharges from hospital, and to readmissions, is the wrong way to proceed. I hope that many Members will join me in voting for amendment No. 5, which would postpone the introduction of this legislation by a year, to 1 April 2004.
	As a sop to Back-Bench Labour MPs who were in revolt on Second Reading, the Secretary of State announced that health service money would be made available to social services to help them pay the fines that they will incur if they fail to comply with this law. However, postponing enactment of the legislation beyond the six months proposed by Lord Hunt following the introduction of this amendment would provide a year during which the money made available by the Department of Health could be invested to improve the situation, and to minimise the problems of delayed discharge. [Interruption.] The Minister nods in a negative way. Does that suggest[Interruption.] Nodding in a negative way may be a contradiction in terms, but that is what she was doing. Is she suggesting that if this amendment were successful and the law's introduction were to be delayed by a year, the Government would not make that money available for the financial year 200304? If so, that differs from what the Government have been saying so far. If notif the money will be paid out this Aprilit would be better to invest the money for a year in the health service, and in local authorities and social service departments, to seek to minimise the problem of delayed discharge. Then, if we have to, we could introduce the system of fines next year, after a year of investing the money to seek to minimise the problem.
	If this legislation is as wonderful as the Minister claims, there should be a sunset clauseamendment No. 45so that it is removed from law within five years of coming into force. The Minister asked what would happen if the problem were solved before then, but the answer is very easy for the Government. All that they would have to do is to repeal the law immediately; they need not wait for the sunset clause to take effect.
	For those reasons, we should agree with the Lords. The Government may find it difficult to believe this now, but they will believe in time that the other place has in fact done them a favour by passing these amendments. In doing so, they have provided a semblance of improvement to what, in essence, is nasty legislation.

Glenda Jackson: As my hon. Friend the Minister knows, I share some of the disquiet evinced by my hon. Friend the Member for Wakefield (Mr. Hinchliffe), who chairs the Select Committee that has dealt with this Bill. In this instance, it seems somewhat less than fair to impute blameessentially, that is what we are doingin respect of an elderly or frail person who is kept in hospital for an unnecessarily long time because social services have not been able to create the proper care environment past their recovery.
	I shall not rehearse the arguments that I made on Second Reading, and I am grateful to the Government for listening to the concerns that have been expressed by my own local authority and by voluntary organisations throughout London. However, in a sense, a period of six months is neither fish nor fowl, nor good red herring. There are specific difficulties, of which my hon. Friend the Minister will be aware, that impact particularly on authorities such as mine, which represent inner-London boroughs. No one could argue that the borough of Camden has been lax on this issue, and I know that the Government would not attempt to do so. It is a beacon authority, and it has made extremely good use of the additional funding provided by the Government. It is assiduous in attempting to incorporate a properly constructed care package, with proper input from individuals or their carers. However, there are real difficulties in central London relating to the availability and cost of properties, and, on the most simplistic of levels, to the availability of a work force who are capable of adapting, say, an individual's private home for the necessary bathroom, shower and fitments, so that they can live within their own property. There are also grave difficulties in ensuring security of domiciliary care, when that is included in the package.
	I raise these issuesI have no doubt that the Minister is aware of themsimply to ask the Government to consider, even at this late stage, delaying the Bill's introduction. As I said on Second Reading, I know that their heart is in the right place. No one wishes to see the elderly or frail kept in hospital if an alternative location would not only probably make them infinitely happier, but ensure their future health. There are real difficulties, but there is no difficulty as far as my local authority social services are concerned in attempting to create partnerships. Indeed, they have created extremely effective partnerships not only with the national health service and the voluntary sector, but with the private sector, which they deal with in many instances, to ensure the creation of a proper care package for individuals. However, there are difficulties in ensuring that internal office systems are the samean issue that is not exclusively the responsibility of local authorities or of the NHS.
	Solving such practical difficulties takes time, and I should point out to the Minister that it also takes money. I have my doubts about how beneficial it is to move 100 million from one aspect of the provision of care to another. However, it would be a shame if the money that the Government are investing were to be spent somewhat hastily not only because of the pressure resulting from the Bill's introduction, but because of the time pressure on the introduction of these requirements. As we know, more haste means less speed, but it also often means spending unnecessary amounts of money.
	I ask the Government to consider the points that I have made and perhaps to delay the Bill's introduction. That would address many of the anxieties experienced not only by my local authority social services department and the NHS, but, most importantlyI stress this point to the Ministerby those who care for the elderly. They are looking for a properly structured care package, and they are anxious about the time pressure resulting not only from the Bill itself, but from its introduction. If it were possible to extend the period before its introduction, many of my constituents would be very grateful.

Paul Burstow: I agree with many of the points that have just been made by the hon. Member for Hampstead and Highgate (Glenda Jackson), and she probably speaks for all Members when she says that we do not want people to be stuck in hospital unnecessarily. That is absolutely the case, and we would support any measures that facilitate appropriate discharges. Our fear and our belief is that the Bill does not facilitate appropriate discharges. Some of the Minister's comments gave me the strong impression that the anxiety of the Government is not so much to secure the appropriate discharge of an elderly person as to free up a bed so as to facilitate other NHS objectives.

Andy Burnham: What is wrong with that?

Paul Burstow: It is wrong if someone is discharged prematurely. That is why we have seen a massive increase

Andy Burnham: Will the hon. Gentleman give way?

Paul Burstow: In a moment, when I have finished answering the hon. Gentleman's sedentary intervention. We have seen a massive increase in emergency readmissions. Indeed, the National Audit Office, in its report on delayed discharges, identified that as a serious risk. A focus on discharges may increase the number of emergency readmissions.

Andy Burnham: Neither the hon. Gentleman nor the Conservative Front-Bench spokesman appears to understand that the decision to discharge is a clinical decision, and nothing in the Bill will affect the clinical decision about when a patient may be safely discharged.

Paul Burstow: The hon. Gentleman is a member of the Health Committee and took part in the evidence sessions. He will have heard the officials from the Department talk the Committee through the definition, and they made it clear that it was not just a clinical decision. They said that the decision to discharge was a multi-disciplinary one.
	When the National Audit Office published its report in February, after we had finished our initial consideration of the Bill, it included some interesting findings that we must consider when deciding whether we should retain the Lords amendments. Those findings make a strong case for delay so that matters may be properly considered.
	The first is the finding of the NAO about the accuracy of the measurement of delayed discharges. According to the report, the NHS finds it difficult to provide accurate and reliable figures. Indeed, a survey found that only 27 per cent. of NHS trusts provided figures based entirely on the definition issued by the Department. Some 22 per cent. of trusts used only a vague approximation of the definition and 44 per cent. did not follow the definition at all and were, therefore, supplying incorrect and unreliable data to the Department. Those are the data being used by Ministers to frame their policy and to demonstrate a reduction in the number of delayed discharges. From the work of the NAO, we know that we cannot place confidence in those figures.
	The NAO report states:
	Continued inaccuracies in this data could affect the effective implementation of the Community Care (Delayed Discharges etc.) Bill, if it becomes law from April 2003, as the data will form the basis for calculating reimbursements payable by Councils to acute hospitals as part of the new arrangements.
	I hope that the Minister will be able to explain why she has such confidence in the figures, given the findings of the NAO.
	The other issue that I hope the Minister will consider is the Coughlan judgment and continuing NHS care. In the light of the health service ombudsman's report last month, real anxiety still exists that the guidance issued by the Department of Health in 2001 is misleading, inaccurate and does not comply with the Coughlan judgment and is, therefore, not in accordance with the law. As a consequence, people are being passed from the NHS to social services departments, where they are means-tested for their care, when they should have continued to be the responsibility of the NHS.
	I hope that the Minister will tell us more about what steps the Department will take to ensure that it issues proper guidance on delayed discharge and discharge planning to clinicians who take initial decisions about the appropriateness of discharge, so that they can make a proper assessment of any continuing health care needs. Clinicians judge not only whether the need is still acute but also whether the need is continuing. If it is, the NHS clearly has a responsibility to continue funding care whatever the patient's location after discharge. That is not clear in the present guidance or in the majority of the rules used by local health authorities to guide those who make the decisions.
	My final concern, which is picked up in the NAO report several times, relates to capacity, which has been a running theme since Second Reading. The report finds that many parts of the countryespecially London and the south-eastnow have occupancy rates of more than 90 per cent. in care homes. The lack of capacity means that the NHS cannot discharge patients. If the Bill were to be implemented from 1 April this year, the extra resources for social servicesfor which I votedwould not be available in time to bring extra capacity on stream. The issue is not only care home capacity, but home care capacity, as the NAO report confirms. There is a shortage of care home workers and new ones cannot be recruited overnight.
	For those reasons, the Liberal Democrats believe that the Lords amendments should continue to stand part of the Bill. The Lords were right and wise to say that the sun should not rise over the Bill until we have got the detailed answers to the points made by the NAO, which we have raised time and again with Ministers without receiving proper answers. I hope that the Minister will be able to reassure us, but I will encourage my colleagues to support the retention of the sunset and sunrise clauses in the Lobby this afternoon.

David Hinchliffe: When the Bill was introduced, several Labour Members wished to consider whether it would be possible to improve it fundamentally. We had grave doubts that the mechanism in the Bill was the right one to adopt in the circumstances. The only common ground we could reach on what amendment could be made is reflected in Lords amendment No. 5, so I support it as all that could be done to improve what is not good legislation. I regret having to say that, but I made my views clear on Second and Third Reading.
	The Government have taken many steps to address is a major problem in the NHS and they have done much to improve the working relationship between the NHS and social services. The Government have produced a definition of a delayed dischargeon that point, I disagree with the hon. Member for West Chelmsford (Mr. Burns), because I recall asking the previous Government about delayed discharges, but they did not even have a definition for them. It is commendable to try to establish what we mean by delayed discharge, because it is useful to know exactly what the problem is before addressing it. However, I take the pointpicked up in the Health Committee's inquiry into delayed dischargesthat several different approaches have been taken to the definition, which will cause problems when trying to apply a common system such as that in the Bill.
	I agreed with some of what the hon. Member for Sutton and Cheam (Mr. Burstow) said a moment ago, and with virtually everything that my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson) said a little earlier. I object to the common thread that appears in debates such as thisthat our problems in this country could be solved by making more institutional care available. The lack of care home capacity is mentioned time and again. It saddens me that that is repeated as though it is factually correct. In this country, the problem is that far too often we have gone down the road of providing institutional care for elderly people. We have not examined how we could take concrete steps to develop alternatives.
	To be fair to the Government, they accept that. It frustrates me that other European countries not very far away provide no care homes or nursing homes at all. People in their old age are afforded much more in the way of independence and rights than elderly people in this country are offered. It is about time that we kicked into touch the nonsensical proposition that we should have more and more institutional care for old people. It is simply untrue.

Hilton Dawson: Does my hon. Friend agree that a good example of what he describes can be found much closer to home than Denmark? The hon. Member for West Chelmsford (Mr. Burns) completely undermined his argument about care home places when he told us how successful the Government have been in introducing partnerships and in forging partnerships between health and social care services. The public, private and voluntary sectors work really well together.

David Hinchliffe: Yes. It is also about time we recognised that a reduction in the number of care home places is a success, providing that we are assured that the alternatives to that form of care are being developed. Far too often, colleagues in other parties assume that the way to make progress on these matters is to provide more and more institutional care in the private sector. I profoundly disagree with that.
	My hon. Friend the Minister said that there were 6,000 inappropriately delayed people in NHS beds. The Health Committee did some costings on the matter, which were very worrying. Money is being wasted that could be invested in treating the people in those beds who need treatment.
	However, as I and one or two others noted on Second Reading, it is worrying that so much emphasis is being given to delayed discharges. As I know from my own local hospital, inappropriate admissions are another significant problem. If we are applying one approach to delayed discharges, it would be inconsistent not to apply a similar approach to inappropriate admissions. I would be more convinced that the proposed mechanism was going to work if it was being applied in an even-handed way, and if it was proposed to establish a mechanism that would push costs back to the people who are making the inappropriate admissions in the first place. Why are they doing that? We need to find out.
	I want to refer to what the Health Committee has said in connection with the amendment. I hope that, on the many issues that we investigate, the Committee's comments are seen to be constructive and helpful. They are made on the basis of the evidence that we take, and on the basis of the cross-party consideration of matters. Committee members belong to different parties, and those that belong to the same party often have different views. Even so, we came to some clear conclusions on the matter, and I should like to refer to a couple of them now.
	At paragraph 162, the Select Committee states:
	While there was some cautious support for the model
	that is, the model being adopted by the Government now
	the predominant reaction was that the proposals constituted a blunt instrument that, rather than improving partnership, would be likely to reinforce a negative blame culture. We are especially concerned that the underlying assumptions behind the charging proposals is that most delays in the system are the fault of social services. As we have emphasised throughout this report, the causes of delay are complex and multi-factoral. It is far from clear that the issue can be resolved by such a crude solution.
	The Government's approach is a crude solution. The Committee also went on to say that it agreed
	that appropriate incentives have a role to play, but we would also urge the development of positive incentives that reward good practice, rather than any precipitate and over-zealous emphasis on penalties. We recommend that any new schemes should be subject to piloting.
	I am sorry that the Government have not picked up on that point. The amendment that proposes a delay of a year is the nearest sensible suggestion to what the Health Committee proposed in the report.
	Finally, these problems come up time and again, in all sorts of bits of legislation. We have a go at them around the edges, but we never address the fundamental problemthe organisational division between health and social services. In the previous Parliament, the Committee, which had a completely different membership, came to the key conclusion that the only real solution is to integrate our health and social care systems. That requires common budgets. The Health Committee's most important conclusion in respect of delayed discharges is that we should integrate health and social services.
	I shall say no more this afternoon. I shall go and lie down now that I have made my contribution. I hope that, at some point, the Government will adopt what is increasingly the consensual opinion among people in the voluntary sector and in pressure groupsthat there is a need to examine the matter radically. Once and for all, we must end the nonsensical division between these two key areas of policy.

George Young: It is a pleasure to follow the hon. Gentleman, who has been brave and consistent in his hostility to the Bill. I agree with what he said about the need to take an even-handed approach rather than just singling out social services for fines.
	I spent yesterday speaking and voting in favour of the Government, but my generosity is curtailed on reaching this Bill, which, as I said on Second Reading, is one of the worst Bills that I have ever seen. The Minister is pushing her luck. As it stands, the Bill comes into effect in April next year. Had there been a vote on Second Reading in the upper House, it would have been lost. There was only one speech in its support and there was nearly a vote, so the Government are lucky that it still exists.
	The Minister tells us that she has listened and that as a result she is delaying the Bill for six months, but when we propose a 12-month delay we are told that we are trying to wreck it. This is not a wrecking amendment. It is supported by Age Concern, the Local Government Association and several peers in another place who support the Minister's party, not mine. She says that the Bill is in the interests of older people, but I wonder whether she is the best advocate for their interests, given that we have received clear advice from Age Concern that it, too, would prefer the delay. The Bill remains fundamentally unpopular. The NHS Confederation, the organisation that it is proposed to assist, is resistant, as are the Local Government Association, the British Medical Association, the nurses and the voluntary organisations. The Bill is without friends.

Nigel Waterson: Is my right hon. Friend aware that in Sweden, whose position is cited in support of the Billthe Government clearly have to go as far as Sweden to find anyone who might speak out in its favourit took some two years to implement similar legislation, but in a much simpler system?

George Young: My hon. Friend is right. That is why several organisations have argued for piloting. Of course, if the measure were delayed for 12 months there would be an opportunity to pilot it.
	The Minister kept talking about the real world, but in reality the only world in which the Bill has any support at all is her world of Health Ministers. If one talks to anyone else, one finds that they are fundamentally opposed to the Bill. She has produced no new arguments. The protests against the Bill are undiminished. It remains fundamentally misconceived. It puts tension where we need partnership and focuses on just one part of what should be a holistic process.

Hilton Dawson: Will the right hon. Gentleman give way?

George Young: I will not, because the Minister should in fairness be allowed two or three minutes in which to reply. I hope that the hon. Gentleman did not support the guillotine that imposed this time scale on our consideration of the Bill.
	If the Minister is well advised, she will save the House one Division, leave Lords amendment No. 5 as it is, and thank her lucky stars that the Bill was not completely demolished in another place.

Jacqui Smith: First, I shall respond to my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson), who identified the pressures on community care services as an argument for a longer delay than I would be happy withI shall come back to the reasons for that later. She is right that we need to build up alternatives to hospital. We need to ensure, as has the 300 million which has been made available over a period of 18 months in preparation for the Bill, that that process allows us to build capacity in the care homes sector and to develop domiciliary care. All our evidence is that that money is already having that effect. We also base the Bill on the fact that from April we will increase investment into social services departments by 6 per cent. in real terms and that we will introduce access and systems capacity grant of 170 million

John Bercow: Will the Minister give way?

Jacqui Smith: No, I will not, because I am winding up. The hon. Gentleman should have stayed for the debate if he was that interested.
	The argument therefore is that we need longer in order to ensure that that money has an effect. Part of our justification for the Bill is that, in order to ensure that the extra investment is going into those community alternatives, we need to focus both on the individual and the incentives. That is what the Bill allows us to do. I repeat to hon. Membersand this was a new argumentthat we now have experience from the field about the momentum that has resulted from this legislation. I hope that I will have the opportunity later of responding to some of the points that were raised by the hon. Member for Sutton and Cheam (Mr. Burstow) on continuing care.
	We have to put in place the incentives necessary to focus

It being three and a half hours before the moment of interruption, Madam Deputy Speaker put the Question already proposed from the Chair, pursuant to Orders [28 June 2001 and 29 October 2002].
	The House divided: Ayes 330, Noes 205.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment: No. 47.
	Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 333, Noes 203.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendments Nos. 4, 10 to 13, 21 and 7, 8 and 39 agreed to.

Clause 2
	  
	Notice of Patient's Possible Need for Community Care Services

Lords amendment: No. 6.

Jacqui Smith: I beg to move, That this House disagrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this we may discuss Lords amendment No. 9.

Jacqui Smith: These amendments raise the crucial issue of involving and informing patients and carers during the notification under clause 2. I am sure that those hon. Members who have taken a close interest in the Bill as it has gone through its stages will be aware that I am referring to the notification from the hospital to social services that starts the process of assessment that identifies to a social services department that the hospital believes that an individual may need community care services so that it is safe to discharge him from hospital. It is an important new responsibility on hospitals to ensure that they improve communication with social services departments.
	The current position is that, in exercising their functions, the NHS and social services must give all proper information to a person so that he can make an informed decision about whether to accept care or services. Those are fundamental duties that stem from the fact that they are public bodies exercising public functions. However, we noted the concerns of both Houses that there is no duty for the NHS to consult the patient prior to referring him to social services.
	Government amendment No. 9, with which I hope the House will agree, will place a duty upon the NHS to consult the patient and, where appropriate, his carer before issuing a notice to the local authority of the patient's likely need for community care services on discharge under what will be section 2. That avoids wasting the time of the NHS and social services by initiating assessments that are not required, and ensures that patients are not involved in an assessment without their prior knowledge and that of their carers.
	The Government amendment reinforces the existing good practice that has been built through experience and emphasised in guidance for section 47 assessments, the single assessment process and the recently published discharge workbook. All those processes are built on the premise that the patient should be kept informed and will be consulted at all stages of the assessment process. Even in the context of the Bill, how could the NHS body decide whether the patient is likely to need community care services in order to be safely discharged without consulting the patient? Lords amendment No. 9 puts the matter beyond doubt by writing the requirement into primary legislation.
	The same applies to involving carers, although the requirement to consult the carer is slightly circumscribed in that the NHS body must consult the carer only if it knows who the carer is, and if it is reasonably practicable to do so. That is to avoid placing a blanket duty on the NHS body that it cannot meet without incurring further delay. The Government have concerns about amendment No. 6 because it is quite a different matter for the NHS to require consent before informing social services. That would be a new right that does not exist elsewhere in the NHS.
	Although to us, discussing the matter in the Chamber, consent may seem a simple, straightforward matter, it may not seem so when presented to older people. They may be confused and fearful, possibly having just had a fall and having come into hospital by ambulance. They may not have any experience of social services or know what an assessment entails, and may not feel able to give consent. The amendment would mean that that had to happen before social services could be involved.
	In situations where older people are not able formally to give or withhold consent, it is important that health and social care professionals can begin talking to the patient, explaining options, understanding their home situation and forming a view about what services they may need for a safe discharge. None of that could happen if the NHS could not notify social services without clear and informed consent to notification. A week or more could go by and the patient might nearly be ready for discharge before they felt ready to give a definite yes, which by that time would probably be a yes to social services providing services.
	Many people have rightly argued for faster and more timely assessment. The difficulty with amendment No. 6 is that it could work against that. The Bill does not prevent a patient from refusing to co-operate with the NHS or social services in assessment; that is their human right. But it would be deeply counterproductive to give a person the right to prevent the NHS from taking the first step to inform local authorities that, for their own well-being and safety, there may be a need for social services. Most importantly, it would do nothing to ensure that people receive the appropriate care and support when they need it and in the right setting. To add the need for consent would require extra and unnecessary bureaucracy, requiring the NHS to gain, record and pass on the record of that consent to social services.

Meg Munn: Is my hon. Friend aware that since the National Health Service and Community Care Act 1990 came into force, many social services and health authorities have had in place systems whereby, as soon as a person is admitted to hospital, the relevant social services authority is notified that an assessment will be needed, so that the procedures can quickly be put in place? Does my hon. Friend agree that the amendment would cause considerable difficulties for authorities that already have sound, quick procedures that operate effectively?

Jacqui Smith: As we have seen from previous debates, my hon. Friend understands the real world in this matter and she has put her finger on the difficulty. We recognise the need to ensure that patients are consulted about a notification of their needs going to social services. That seems reasonable, and the Government amendment will ensure that that happens. However, we fear that the Lords amendment could put a spoke in the wheel of the sensible arrangements to which my hon. Friend refers, and that would not achieve what all of us want to see, which is a more timely and appropriate assessment for people in hospital in order to provide them with the necessary support. As I emphasised earlier, people will still have the right not to participate in that assessment and to refuse the services, but to place individuals and organisations in a position where they have to obtain full consent before a notification could even take place would not deliver the sort of improvements that we want.

Paul Burstow: I want to persuade the House that it should not agree with the Minister but instead should agree with Lords amendment No. 6, and I shall explain why.
	First, I welcome Lords amendment No. 9 because it provides a movement in the direction that I think hon. Members on both sides of the House wish to see, recognising the need for a process that ensures that carers and patients are consulted.
	The crux of the debate is about whether consent puts a spoke in the wheel, or whether it should be a legitimate part of the Bill. Many hon. Members, and many people outside the House, are concerned that, by not referring at all to patients' rights in terms of being consulted or being able to exercise their right to informed consent, the Bill is not patient centred. In many ways, the Bill could be described, uncharitably perhaps, as regarding patients as passive recipients of a process of care, establishing a process and set of mechanisms whereby they are merely passed from one authority to another. I do not think that that is what it should be about.
	In Lords amendment No. 6, my noble Friends in the other place sought, I think succinctly, to include in the Bill the much-needed right of carers to be consulted, which is important, not least in the light of research by Carers UK, which found, when it surveyed carers on their experiences of delayed discharge and the management of a person's discharge, that their views were taken into account less in 2002 than they had been in 1998. It is on that basis that I and my noble Friends came to the conclusion that simply relying on the hospital's discharge workbook would not be enough. It may well contain excellent practice or good practice, but we want clear law, not just guidance, to NHS and other practitioners.
	The amendment seeks to place a proactive duty on the NHS and social services to offer assessments of care to carers, not just to wait for the carer to ask. That was an important concern that we had when the Bill left this place.
	The other point that the amendment seeks to raise, which the Minister did not really address, concerns mental capacity. The Minister referred to that at least in passing by suggesting that professionals would be hamstrung if they were unable to obtain informed consent. Yet the reality is that the amendment would include in the Bill a requirement that, where a person lacks the mental capacity to give such consent, a record should be placed on the file of the steps taken to ensure the patient's best interests. That places on record within the NHS the process by which the clinicians came to a decision that it was in the person's best interest for social services to be involved and for other decisions to be made.
	As we do not have in our law a recognition of mental incapacity in respect of a person's right to advocacy or surrogate decision making in terms of health care, this is a way of encouraging the Government to consider the matter now, because it is an integral part of making the Bill effective and patient centred. That is why we make the proposal.
	To conclude, I want to touch on one other issue. I hope that, even at this late stage, the Government will be prepared to consider finding a way by which further amendments can be made to address this concern. That is what my noble Friends were seeking to achieve, and that was the opportunity that they presented. I regret that that opportunity has not been taken. There is a serious issue in relation to how we ensure that those who do not have capacity can have their wishes reflected on, acted on and properly documented, and how those who do have capacity can have a say on whether they wish social services to intervene and make an assessment of their needs. Surely that is their right, although, currently, the Bill does not reflect that. I hope that hon. Members will establish that right clearly in the Bill today, and not accept the Government's dissent from the amendment.

Glenda Jackson: I have listened to the arguments of my hon. Friend the Minister. Although I am not necessarily especially moved by the Lords amendments, I would like to mention some issues that have been raised with me by constituents in relation to health professionals and social services listening to carers, as well as the issue of mental capacity, which has been touched on.
	I know that the Government have made major moves in relation to incorporating the opinions of carers when creating a truly effective care package for an individual. I hope, however, that they will consider a problem, which, although not massive, is real for the individuals and families concerned, and which has caused difficulties in my constituency. The problem is that, on some occasions, health service professionals and, in other instances, social services suddenly get very exercised about issues of confidentiality, which seems to me to be absolutely unacceptable.
	In the case of someone who has a mental incapacity, it is very unusual in my borough of Camden for there not to be an extremely efficient, caring advocate, whether that is an official or someone who has simply taken it on themselves to become a carer for an elderly person without a family. If the issue of confidentiality is raised, however, and that involves the input of the individual carerwhether a family member or an advocate for someone with a mental incapacityit slows the system down. Under the Bill, there can be fines[Interruption.] I know that my hon. Friend the Minister does not like that word. None the less, financial penalties can be incurred if there is what is deemed to be a delay in the discharge. It may be that the issue of confidentiality is being exercised because people believe that that is in the best interests. Indeed, sometimes, they may erroneously believe that they will be infringing some kind of ethical, if not legal, embargo.
	I understand the Government's arguments against the Lords amendment, but I ask them to consider this issue. I am happy to furnish my hon. Friend the Minister with anecdotal evidence from my constituency, as the Government should be aware of it. As I have said, not only can the process be delayed but real difficulties can be caused for families, for the individual for whom they are caring, and, most particularly, for those who suffer from a mental incapacity, in relation to their advocate. It is not unusual, in the first instance, for attempts to be made to sideline their contribution. Importantly, too, those people who are closely engaged with an individual can offer good ideas as to what would be the best possible care package for that person.
	Although I will not vote for the Lords amendment, I hope that my hon. Friend will take on board the points that I have made, and I am happy to provide her with even more details if they can be of help.

Nigel Waterson: I shall be brief because we have much ground to cover. The basic challenge to any Opposition is the extent to which they should strive to improve a measure that is fundamentally unimprovable. However, the central objection has always been that the Bill is not patient centred. Almost everybody in the world, except Health Ministers, takes that view. It is a tribute to the sustained opposition from all quarters, not only parliamentary, that the Government have been dragged kicking and screaming towards at least nodding in the direction of patients.
	The Minister claims that the amendment would grant a new right that does not exist in the NHS. She may be right. However, the Government are taking some draconian new powers, which do not yet exist, over the NHS and social services. It is only fair that those powers, which are misconceived and bound to trigger the law of unintended consequences, are counterbalanced by stronger rights for patients.
	In an ideal world, consultation would mean an unhurried attempt to sit down with the patient, carer or both, discuss the options, ensure that the patient has all the available information, and reach a consensus. However, how can we guarantee that in the real world? The only way is to include the word consent in the Bill. There would thus be an absolute requirement to obtain the consenthopefully informedof a patient or carer before the shift to some other form of care.
	In the majority of cases, obtaining consent should not present a problem. All too often, the patient clamours to get out of hospital into more appropriate care. However, in a small minority of cases, there will be a clash of views between the patient, the family, the carers and the aims of the health professionals. Those aims will be driven by the financial penaltiesincentives, as the Minister calls them, fines as everybody else, including the Secretary of State refers to themthat the Bill imposes.
	It would be churlish not to welcome the Government's deathbed conversion to the patient having some role. Until now, the patient has been regarded as a commodity, to be shunted back and forth in the system as rapidly as possible in a bizarre game of pass the parcel to ensure that whoever has the patient when the music stops pays a fine. For once, the Government are beginning to acknowledge that a patient plays a genuine role in the process.
	It is only fair to record that Age Concern has welcomed the Government's comments about consultation, guidance and so on. However, Age Concern is not alone in the view that it expressed in its latest briefing, which states:
	Age Concern believes that it is essential that older people have the right to agree to their care package and that this requirement is explicitly spelt out on the face of the Bill.
	That does not mean setting out a requirement in regulations or guidance.

Meg Munn: Community care legislation has been in place for nearly 10 years. Expectations about agreement to care packages have also existed for that time. We are not discussing anything that is new or relates specifically to the issues that the Bill tackles.

Nigel Waterson: If that is a point in favour of patient consent and agreement between everyone, who am I to disagree? Of course, there should be agreement, and I said that the problem will affect only a minority of cases.
	Age Concern's briefing, reflecting the point that the hon. Member for Hampstead and Highgate (Glenda Jackson) made, continues:
	This is especially important with this Bill which will allow information to be passed from one authority to another (NHS to local authorities).
	The hon. Lady was right. Problems with confidentiality may slow down the process. That is not a matter for us; it is for Ministers and civil servants to tackle so that there is no extra cause of delay. Age Concern concludes:
	We strongly urge MPs to keep this requirement on the face of the Bill.
	I think that Age Concern is absolutely right.
	The combined opposition to the Bill from within and outside Parliament has persuaded the Government to look at the rights of patients. They have not gone far enough down that road, however. They should go the whole hog and withdraw their opposition to this eminently sensible and fair Lords amendment.

Jacqui Smith: With the leave of the House, I should like to respond to the hon. Member for Eastbourne (Mr. Waterson) first. Most of his contribution was about consenting to a care package. He has, therefore, misunderstood the section of the Bill that we are discussing. The two amendments in question relate to the process whereby the NHS body, the hospital, notifies social services that someone might need community care services, thereby starting the process of assessment. We have not yet reached the question of the care package, although I hope that we shall do so when we discuss the next two groups of amendments. It would, therefore, have been better if the hon. Gentleman had saved some of his arguments for later.
	I reiterate the point that I raised earlier about amendment No. 9, which is that it ensures that, even before that notification happens, the patient and carer will need to be consulted about the fact that the assessment process has started. That is an important step forward.

Paul Burstow: I want to seek clarity on amendment No. 9, in which paragraph (b) refers to the circumstances in which carers should be consulted if it is reasonably practicable to do so. Will the Minister amplify what would be meant by reasonably in those circumstances, so that we can help those outside who will have to live with this amendment in future?

Jacqui Smith: As I started to outline in my introduction, this provision is intended to avoid a situation in which an inability to find a carerperhaps because a patient was not clear about who their carer was, for example, or because the carer was away or uncontactable at the relevant timewould put a brake on the ability to notify social services and start the assessment. In such circumstances, we would not want the notification of the assessment to stop.
	The point of difference between us is whether we should make it a requirement for the patient to consent to the notification of social services to start the assessment. My hon. Friend the Member for Hampstead and Highgate (Glenda Jackson) raised some important issues about capacityas did the hon. Member for Sutton and Cheam (Mr. Burstow)and confidentiality, which seemed to go to the heart of the need to have in place a better way for those without capacity to have determined in advance who might take these decisions on their behalf. I am pleased that the Parliamentary Secretary, Lord Chancellor's Department, my hon. Friend the Member for Doncaster, Central (Ms Winterton) is on the Front Bench today to hear these concerns. Hon. Members will be aware that the Lord Chancellor's Department is currently working on draft legislation on incapacity, and I understand that my hon. Friend has also set up a mental incapacity forum to deal with some of these issues. The Government are, therefore, considering them in detail.
	To return to the crux of the matter of obtaining consent, I would ask hon. Members to imagine the position in which we might place a hospital if, for example, someone had come in following an accident in which they had fallen over and were confused, and it was clear that they would almost certainly need community care services in order to be able to be discharged from hospital. Under amendment No. 6, the patient would have to give their informed consent before the social services could even be notified to start the process. My concern is that, for a variety of reasons, they might not be able to do that. In addition, all the bureaucracy involved in obtaining consent would, in such a case, increase the period of time between the patient being admitted and social services being informed of the possible need for care. That could reduce the time available to social services departments to plan and arrange a care package.
	Nothing changes the fact that patients need not co-operate with assessments. They can refuse the package offered to them. Nevertheless, professionals must be involved at every stage to ensure that patients understand the consequences of refusing care, rather than a box being ticked for consent given or consent not given.
	While it is unlikely to add to the process of consulting patients, what is proposed in the amendment might add to both the problems involved and the time taken before health and social care professionals can start working together to assess people's needs and to ensure that the necessary services are available. I hope that Members will disagree with Lords amendment No. 6, and agree with Lords amendment No. 9.

Question put, That this House disagrees with the Lords in the said amendment:
	The House divided: Ayes 328, Noes 198.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment No. 9 agreed to.
	Lords amendment: No. 14.

Jacqui Smith: I beg to move, That this House disagrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this it will be convenient to take Lords amendment No. 15 and Government motion to disagree thereto, Lords amendment No. 16 and Government motion to disagree thereto and Lords amendment No. 18 and Government motion to disagree thereto.

Jacqui Smith: Although I am proposing that we disagree with the Lords in these amendments on the important issue of informing and involving patients and carers in the performance of the social services assessment and decisions about which services are to be provided, I hope that I can give hon. Members some reassurance that the Government have gone even further than the aspirations expressed in the Lords amendments in what we propose to do.
	Amendments Nos. 14 and 15 propose that local authorities should consult patients and carers during the assessment of community care needs and obtain their consent to the care plan. Amendment No. 16 would further require the local authority to inform patients of the costs of this care.
	It is clear in clause 3(11) that this assessment and care planning process is part of the section 47 assessment process and that it is therefore one stage, or part, of the single assessment process. By singling out this assessment and care planning process from all other section 47 assessments and care planning, we would differentiate the process under this Bill from all other processes of assessment and care planning. That would include processes outside the hospital and those applying to other patients in the hospital who do not happen to be qualifying patients according to the terms of the Bill.
	We are very clear that there should be no difference in the type or standard of assessment to which a person is entitled, whether they are assessed in hospital or in their own home. I do not believe that that is what the amendments are designed to achieve. I would have thought that if it was necessary to reiterate these steps herealthough they are set out already in statutory guidance for both section 47 assessments and the single assessment processthen it must be necessary for all assessments, not just for those in this Bill. We have always been clear that the Bill should not affect the underlying substantive law, and we would not want to agree an amendment that did just that.
	Similarly, it has always been the case that care plans prepared as a result of a section 47 assessment should be agreed by the user. That point was made earlier by my hon. Friend the Member for Sheffield, Heeley (Ms Munn). Providing information about costs of care services is covered specifically in the section 7 guidance to local authorities on the single assessment process. Furthermore, it was covered in the statutory guidance on section 47 assessment that was issued to accompany the National Health Service and Community Care Act 1990.
	With respect to assessments carried out under section 47, case law is already clear that the local authority must make reasonable efforts to provide patients with their chosen options, as long as there are no resource implications to prevent that. In reality, it would not be possible for the local authority to do that without having first consulted the patient to ascertain how he or she feels about the various choices available.
	The Bill makes no difference to a patient's rights with respect to consent. Patients have an existing right not to consent to receiving the services that social services has assessed them as needing. Clearly, neither the NHS nor social services has a right to force services upon a patient who does not want to receive them.
	Of course, good practice will dictate that patients should be kept informed and that they should be consulted at all stages of the discharge process. The revised hospital discharge workbook has a chapter specifically on patient and carer involvement. We will expect both NHS and social services staff to follow it. The statutory guidance for the Bill will also make it plain that patients and their carers and family are to be kept fully informed and consulted throughout the discharge process.
	It is a slightly different case in terms of a carer's assessment, which is actually triggered by a request from the individual carer. There can therefore be no question of consent to the assessment, since it is implicit in the request for an assessment that the person involved has consented. In terms of agreeing the carer's plan, the statutory guidance is clearthe plan must focus on what the carer wants to happen, and agreement, or any differences between carer and assessor, are recorded and a copy provided to the carer. Moving away from this arrangement, as suggested in the amendment, would differentiate carers' plans from others. The amendment would make these plans less responsive to the carer's wishes than other carers' assessments carried out under section 2 of the Carers and Disabled Children Act 2000.
	However, as I suggested earlier, I understand that the first three amendments in this group are trying to strengthen the arrangements around assessment and care planning. I hope that I made it clear that, if that is needed, it should be all section 47 assessments, regardless of where or when they take place.
	Section 47(4) of the National Health Service and Community Care Act 1990 contains a power for the Secretary of State to issue directions as to the manner in which assessment is carried out. I can confirm, therefore, that we will issue a direction under this power to make it clear that the local authority, having assessed the needs of the patient, should consult the patient before deciding which services to provide. Where possible, it should gain agreement to the care plan, and provide information about the costs of that care plan.
	That direction would apply to all section 47 assessments. It would not create the divergence that these amendments would create, but I hope that it offers some reassurance to the House that these important issues are being addressed.

Paul Burstow: Some of the issues that we are debating under this group of amendments are a re-run of those that we debated a few moments ago, so many of my previous arguments also apply. We are now talking about the care planning process, as opposed to whether consent should be passed on social services in the first place.
	I listened with interest to the Minister's comments to the effect that the amendments that were tabled by my noble Friends and other noble Lords cover only one particular stage of the assessment process, and I welcome her suggestion that the Government will issue section 7 guidance to apply these matters to all stages of the assessment process under section 47. However, if the Government are now minded to do that, would it not have been easier to table an amendment to the Bill to place it beyond doubt that it was part of the law of the land and a requirement on parties to assessment processes, whether they be NHS bodies, social services departments or any others? Although I find the measure a helpful step forward, it does not sufficiently answer my concern, or that of my noble Friends, that the provisions that we should like to be included in the Bill are not yet there. The amendments are intended to ensure that the issues of consent and mental incapacity are addressed fully and clearly in the Bill. For that reason, we particularly want to press amendments Nos. 14 and 18 to a vote so as to test the opinion of this House before the Lords considers the matter again.
	My other question relates to the section 7 guidance that is to be issued. In the other place, Lord Hunt said that it was intended that a clear guidance or direction should be issued to the national health service in respect of continuing care assessments, that it would be put in writing as part of the process and that it would have to take place before a section 2 notice could be issued. Can the Minister confirm that that is the case, and can she explain why the provision is not included in the Bill, where it would be much clearer to all of us?
	I shall certainly wish for votes on amendment Nos. 14 and 18, and I hope that the Minister can respond to my queries.

Glenda Jackson: The two issues that I should like to raise with my hon. Friend the Minister have essentially to do with consent. In my experience from my constituency, a carer will often find the health professional's definition to be simply incomprehensible. There is far too little movement in terms of the ability of health professionals to translate clinical assessments into the kind of English that most people would understand. That is particularly pertinent when the carer is also elderly.
	The other issue concerns consent. It is not unusual for an elderly person who has been in hospital to be absolutely desperate to go home and absolutely to refuse any kind of alternative. That can often place an enormous burden on their carer, who, as I said, may be of an equal age. The individual concerned may be going back to a home that is completely inappropriate to their new needs. It is therefore not unusual for the idea of a temporary convalescent homeI still call them that, although I know that the situation has changedto be presented so that the necessary adaptations to the family home can be undertaken. However, such homes can be a long way from where people live. Often, for the best of reasons to do with consent, the individual may place a terrible burden on their carer. Indeed, it is not unusual for the carer to end up in hospital.
	I am not being quite as precise as I would like to be, but I hope that my hon. Friend the Minister has picked up what I mean. There can be a fine line. Without wanting there to be a kind of prison state, I would like, when consent is given by the social services and the NHS to what the patient wants, better explanations to be given to the individual and their carer of the possible repercussions if the only proposal that is acceptable to the individual is to go immediately from hospital to home.

Simon Burns: I do not wish to detain the House for long, but I wish to speak to Lords amendment No. 16, which was successfully passed in the other place. It deals with clauses 2 and 3, which are to do with the determination of need for community care services on discharge. I am sure that hon. Members would agree that that is the nuts and bolts of this legislation. As you will be aware, Mr. Deputy Speaker, clause 2, under the heading of
	Notice of patient's possible need for community care services,
	gives the background rules, regulations and legislation. Clause 3, to which Lords amendment No. 16 refers, goes into greater detail on what has to be done during the process. The amendment seeks simply to add to the duties that the responsible authority must carry out. Clause 3(3)(a) says that the responsible authority must
	carry out an assessment of the patient's needs with a view to identifying any community care services that need to be made available.
	Clause 3(3)(b) says that the authority must,
	after consulting the responsible NHS body, decide which of those services . . . the authority will make available for the patient.
	This amendment specifies that, before making a decision under clause 3(3), the responsible authority should have certain duties to carry out to give more power and involvement to the patient and carer. There are straightforward common-sense things that I would assume that no one would disagree withalthough I may be proved wrong. For example, there is the duty to
	consult the patient and his carer, if he has one;
	the duty to
	inform them of the cost of the proposed care plans;
	and the duty to
	obtain the consent of the patient.
	Those duties are an important improvement to the legislation and I hope that the Minister, having had time to reflect since the amendment was passed in the other place, will come round to the logic and advantages of accepting it. If she is not prepared to accept it, I will ask, Mr. Deputy Speaker, whether I may press it to a Division. I hope that it will not come to that. Even at this late stage, I hope that common sense will prevail and that the Minister will think again.

Jacqui Smith: I have a slight feeling that hon. Members are looking a gift horse in the mouth. Most of what the hon. Member for West Chelmsford (Mr. Burns) was arguing for represented good practice that would be desirable in the assessment of the provision of services. However, if the duties that he spoke about were put into the Bill, they would apply only to assessments that came under this legislationin other words, to assessments relating to the services necessary for people to be safely discharged from hospital.
	The argument that I obviously failed to get over in my introduction was that, if those things are important in relation to one part of a section 47 assessment, they are important in relation to all section 47 assessments. That is why I said that we would issue legally binding directions which would make it clear that the local authority, having assessed the patient's needs, should consult the patient before deciding which services to provide, gain agreement to the care plan where possible and provide information about the cost of the care plan. That would apply to all section 47 assessments and would also cover the point made by my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson), who was rightly concerned about the extent to which both carers and patients could engage in and understand the assessment process and the services provided.
	The directions will make much more explicit what is expected and the process that should be undertaken.

Paul Burstow: The Minister seems to be arguing that it would not be possible to apply those important consent and consultation changes to all aspects of the assessment process. Surely the long title of the Bill has been drafted so widely that it would allow the Government to make precisely the amendments that the Minister intends to introduce under a section 7 direction. Would not it be better to include such provisions in the Bill?

Jacqui Smith: I was talking not about section 7, but about legally binding directions. We have already argued about whether our proposals would make the procedure more flexibleI think that they would. For example, they would enable us to introduce other changes in the future; but if the provisions were in the Bill such changes would necessarily be more difficult to make, due to the times at which we can change primary legislation.

Simon Burns: rose

Jacqui Smith: I shall give way in a moment, but I want to deal with the point made by the hon. Member for Sutton and Cheam (Mr. Burstow) about continuing care criteria, in case I do not have the chance to do so later.
	I can confirm that we shall issue a direction requiring a continuing care assessment before the section 2 notice is issued and that regulations will require that to be confirmed in a section 2 notice. That direction will be legally binding and will have the same force as if it was a provision under the Bill, but it will be easier to change in the light of experience. It will place an important legal responsibility on the NHS to carry out continuing care assessments before the local authority is notified. I know that the hon. Gentleman has been concerned about that point.

Simon Burns: Will the Minister give us some clarification about Lords amendment No. 16 so that there are no mistakes or misunderstandings? Did she say that the legally binding direction for the guidance would categorically and comprehensively include all the elements of Lords amendment No. 16? Will the amendment thus be irrelevant, because the Minister is dealing with the matter under legally binding guidance? Yes or no?

Jacqui Smith: I spelt out what the guidance would cover. If the hon. Gentleman is actually pushing me on the issue of consent, I also said that the Bill makes no difference to patients' rights in respect of consent. Patients already have the right not to consent to services that social services departments have assessed them as needing. Neither the NHS nor social services departments has the right to force services on a patient who does not want them.
	Our proposals for continuing care would strengthen responsibility during the whole assessment process, before social services were even involved. I hope, therefore, that hon. Members will agree to reject the amendment.

Question put, That this House disagrees with the Lords in the said amendment:
	The House divided: Ayes 321, Noes 202.

Question accordingly agreed to.
	Lords amendment disagreed to.
	It being less than two hours before the moment of interruption, Mr. Deputy Speaker put the remaining Questions necessary to dispose of business at that hour, pursuant to Orders [28 June 2001 and 29 October 2002].
	Lords amendment No. 15 disagreed to.
	Lords amendment: No. 16.
	Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 321, Noes 203.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment: No. 18.
	Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 320, Noes 203.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment: No. 23.
	Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 322, Noes 206.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendments Nos. 17, 19, 40, 42, and 44 to 46 agreed to.

Clause 3
	  
	Duties Arising Where a Notice Under Section 2 is Given

Lords amendment: No. 24.

Jacqui Smith: I beg to move, That this House disagrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this it will be convenient to discuss Lords amendment No. 25 and Government motion to disagree thereto.

Jacqui Smith: The amendments would impose a permanent statutory duty on inspection bodies to monitor the impact of the Bill on patients and carers, and a permanent statutory duty on the Secretary of State to report annually to Parliament. The implication seems to be that health and social care professionals will irresponsibly discharge patients with inappropriate care packages, but we do not believe that this will be the case. Of course, they will also duplicate safeguards and inspection mechanisms already in place, and will jeopardise the independence of those that are planned.
	NHS and local authorities should, of course, already monitor the quality and effectiveness of their discharge arrangements, which are subject to the normal performance management, performance assessment and monitoring and inspection arrangements. Current inspection bodies already monitor the quality of discharge arrangements and the effect on patients and carers as part of their normal inspection and monitoring activities. For example, the social services inspectorate monitors the quality of services to older people. This will include the achievement of national priorities and targetsincluding the proportion of those helped to live at home, compared with residential careas well as local improvement plans. As part of that, it will of course look at the quality of community support following discharge from hospital. It will also question the balance between investment in services and the amount spent on reimbursement charges.
	In a similar way, when the Commission for Health Improvement reviews clinical governance arrangements within a hospital, it covers planning of patients' entire hospital stay and their discharge. That is an important part of its review methodology. Of course, where a combination of performance indicators and inspection points to particular problems in a given area, the inspection bodies and, ultimately, the Secretary of State have an escalating power to intervene, and to ensure that action is taken to improve outcomes and performance.
	As hon. Members know, we have introduced legislation to establish two new health and social care inspectorates: the Commission for Health Care Audit and Inspection and the Commission for Social Care Inspection. We have already stressed that those bodies will strengthen the accountability of those responsible for the commissioning and delivery of health and social services, and an important part of this role will be for both inspectorates to report annually to Parliament on the provision of NHS and social care. However, we have also stressed their independence from the Department, so although they will agree priorities with the Department, it would not be appropriate for detailed instructions such as those proposed in the amendments to pass from the Secretary of State to the inspectorate concerning the details and the frequency with which they need to inspect particular elements of older people's services.
	We do not believe, therefore, that it is necessary or appropriate to impose that permanent and specific statutory duty on the inspection bodies to monitor the effects of this Bill, or to impose a duty on the Secretary of State to report every year to Parliament specifically on the Bill's effect.

Simon Burns: I should say at the outset that I am very disappointed with the Minister's assessment of, and views on, two very valuable and important amendments for the raising and maintaining of standards. This Government have rightlyI am not criticising themalways maintained that patients, the NHS itself and the professionals who work in it should attain the highest possible standards, and that the quality of care should be of the highest level. I can assure the Minister that I do not disagree with her one iota on that important issue. As constituency MPs, we owe that to those of our constituents who may use the national health service, and to the NHS itself because of the professionals who work within it. What surprises me is that the Minister, by rejecting the amendments, does not seem to share our enthusiasm for ensuring the highest quality and standards in all areas of the NHS.
	For example, Lords amendment No. 24, notwithstanding the Minister's comments, seems eminently reasonable. It asks that
	The Secretary of State shall specify to the bodies charged with inspection of health and social services that they should monitor, at regular intervals, the impact of this Act on patients and their carers.
	On the face of it, that seems to be a welcome added benefit to health and social care. So that the Minister fully appreciates the intention behind the specification that the Secretary of State would be expected to make, I confirm that the bodies that would be charged with the responsibility would be the Audit Commission, CHIand its successor, if and when other legislation is introducedand the social services inspectorate.
	The Government have been in power for six years now, during which time they have taken a perverse pleasure in examining every nook and cranny of our national life. They have not been averse to increasing bureaucracy, but when the other place makes an eminently sensible suggestion to ensure that standards are maintained, theysomewhat churlishly on this occasionreject it. Under the Bill, the patient should be the most important part of the equation of the provision of health care, but the pressures that will be placed on social services by the fines system will mean that the patient will be the piggy in the middle, caught between the NHS and local authority social services departments.

Greg Knight: My hon. Friend is making an effective case and demolishing the Minister's arguments. Is not the Minister wrong when she says that the amendments imply that some sort of wrongdoing is likely to take place? The words added by the other place refer to monitoring and to reporting back to Parliament and, in a democracy, that is eminently sensible and desirable.

Simon Burns: I am indebted to my right hon. Friend. Perspicacious as ever, he has anticipated a point that I was about to make. In all candour, I was surprised and shocked by that comment from the Minister, because it was unfair. Nothing in any amendment to health legislation that I have supported has ever criticised or cast doubt on the huge professionalism of the staff at all levels of the NHS. It perplexed me, listening to the Minister, and I carefully read the words again in case the other place haduncharacteristicallyslipped up. I could not see that it had, and I am sure that the Minister will wish to rectify her comments later.

Nigel Waterson: I shall try to be charitable to the Minister and suggest that she and my hon. Friend are simply and genuinely at cross-purposes. When the Minister talks about the existing inspection and audit regime, that is fine, but we are talking about a Bill that may have all sorts of unintended consequences. If those consequences are undesirablebecause, in the real world, it is just possible that the Minister could be wrong about the Billthe sooner that we identify by specific audit any national trend that suggests that, the better for all of us.

Simon Burns: My hon. Friend has made an important point, and he is right. We must ensure that we get the legislation right at this stage. I must say that I took umbrage at one point in my hon. Friend's intervention when he suggestedunless I misheard himthat the Minister was at cross-purposes with me because she wanted the best in this legislation. I find that difficult to reconcile in one respect. How can the Minister want the best for the Bill when she is bringing in a rather nasty system of fines on local authorities? That does not equal wanting the very best from the Bill. The Bill will do exactly the opposite of providing the very best.
	Before those helpful interventions, I was saying that the Bill will mean that patients become caught, like piggy in the middle, between the NHS and local authorities. That will happen because the Bill will pressure authorities to discharge patients to avoid a fine. I am sure that the Minister does not want patients to suffer in any way. She is talking to her silent Whip at the moment; if she were listening to me, she would be able to hear what I want to tell her in all sincerity. However, she is clearly not listening and will therefore have to read Hansard.

Jacqui Smith: I have heard it all before.

Simon Burns: The Minister says that she has heard it all before, which is odd, as I have not presented this amendment before. It has come from another place, where common sense has prevailed and caused the Government to suffer a defeat. The Opposition in this House are trying to save the Government from making another mistake in overturning the amendment.
	Before that rather cruel interventionthe Minister cannot have heard my speech beforeI was saying that it is important that patients do not suffer. I am sure that the Minister agrees with that. However, the Bill could cause them to suffer as a result of the possible early discharge from hospital to residential care or to domiciliary care in their own homes. That discharge could happen because local authorities want to avoid fines. The result could be emergency readmissions, or an unacceptable level of readmissions to hospital, within a seven to 28-day time scale.
	In an earlier debate, I set out the rising incidence of emergency readmissions to hospital among people aged over 75. The statistics show that there is a problem, and I argued that it could be exacerbated by the Bill. Amendment No. 24 would help to minimise that potential problem.
	Similarly, in the rush to avoid a fine, patients could be discharged into inappropriate care, or into the least appropriate care. No one wants that to happen, but it may be an unfortunate consequence of the possibility that local authorities could be fined. Alternatively, patients could be discharged to their own homes without adequate support services from either the NHS or the local authority social services department. Carers could suffer because undue burdens are placed on them when patients are dischargedby local authorities wishing to avoid being finedwithout the support of a proper and comprehensive care package.
	Amendment No. 24 would alleviate those potential problems. It would allow the situation to be monitored, as reports would be made to local authorities and the NHS. In that way, the problems that could arise would be minimised. For that reason, the Minister got it wrong when she criticised the amendment in her opening comments. She should think again.
	Amendment No. 25 is eminently sensible. It would straightforwardly require the Secretary of State to report annually to Parliament on the outcomes of patients affected by the provisions in the Bill. I should have thought that the Government would warmly welcome that. Certainly, in opposition, they were strong proponents of open government. We have heard the rhetoricthey have talked the talk, but they do not often walk the walkthat people should be empowered with information and knowledge. The amendment represents a classic example of that. It is justifiable that Parliamentwhich will, if the Government get their way, pass this unpleasant Billshould be made aware of the outcome of the legislation that it passes. That is not an unreasonable requirement, and I should have thought that the Government, in the spirit of open government and empowering people with information, would be prepared to accept it.
	There may be an overriding reason why the Government do not want the Secretary of State to be required to report annually to Parliament on the outcomes of patients affected by the legislation. Perhaps, in their heart of hearts, they accept the arguments that my right hon. and hon. Friends and I, as well as the Liberal Democrats, have been making for many monthsthat the Bill is counterproductive and highly damaging, that it will destroy partnership working between the health service and local authorities, and that it will have an adverse impact on patients because it will increase pressures on the early discharge of patients, especially elderly patients over the age of 75. As is shown by the statistics that the Government have produced in recent months, those pressures have led to a rising level of emergency readmissions. In fact, it is probably the case that the Government do not oppose the principle of amendment No. 25, but fear its consequences, in that it would annually reveal to Parliament the failings of the legislation. Moreover, it would show how right the Opposition have been to oppose the Bill root and branch and how misguided Ministers and their followers on the Back Benches have been to press ahead with it in defiance of all the evidence that it is not a good piece of legislation.

Greg Knight: Is not there another argument that the Minister might find more attractivethat is, that if the legislation works well, members of the Government would have an annual opportunity to come to this House to say so?

Simon Burns: My right hon. Friend makes an interesting point. He knows as well as I do that some members of the Government are not as keen on coming to this place as others. In some cases, the amendment could represent an opportunity to ensure that they are here, and it could become an annual visit, so it has that extra potential benefit.
	I hope that the Minister will, in the spirit of maintaining the highest possible standards and of open government, be minded to think again. I am not confident about that, but perhaps I can encourage her by saying that I will ask at the appropriate moment to divide the House on amendments Nos. 24 and 25.

Paul Burstow: I support the amendments because it is appropriate to ask the various inspection agencies covering health and social care now and in future to monitor the implementation of the legislation, and, not least, because the Minister has been unable to answer several questions in the course of the debate, and by monitoring the situation closely we might begin to get some of those answers. Earlier, I referred to the National Audit Office reportand specifically to the accuracy of data that were being supplied on the numbers of people who are suffering delays in their discharge. I was a little disappointed that the Minister was unable to cast any light on Government actions in response to the NAO's findings and was unable to say whether the Government accepted the NAO's conclusion that there were difficulties that would impact on the Government's ability to implement the system of fines that the Bill would introduce. More than four out of every 10 NHS bodies that are responsible for submitting data on the numbers of people who are experiencing delays appear not to be following the Government's definitions. That is a problem.
	However, it is not only what the NAO is saying that causes concern. Not surprisingly, local authorities, in partnership with their local NHS, are trying to test how the system would work. A colleague of mine from a metropolitan authority in the midlands told me:
	There is also a problem over definitions (there almost always has been but local work had, we thought, given . . . agreed definitions). A recent batch of 9 discharges from a local hospital went through a trial run to see what the results of the delayed discharge scheme would be, and the social services department thought they had agreement that only one of the discharges would count
	for the purposes of the fine system. However, when the department went back to the NHS trust, the trust declared that nine would be counted as delayed under the legislation. That was clearly a trial exercise to see what would happen, but it bears on the issue of clarity of definition. That clarity is still not in the Bill. The NAO has raised concerns about that.
	Another issue that I hope will be contained in an annual report to Parliament, and that certainly ought to be subject to monitoring by the Commission for Health Improvement and the Commission for Social Care Inspection, is the interface between health and housing and social care. From 1 April, the supporting people programme will be rolled out across the country. Large amounts of money will be reorganised and distributed by local authorities to pay for supporting people in their own homes and in settings such as sheltered accommodation. However, I was surprised to learn recently that guidance on how the supporting people programme fits with the single assessment processguidance that one would have thought should have been provided by now to local authoritieshas not even begun to be written. The group that will do that work has not even been called together. It would therefore seem appropriate to have in the Bill a measure to enable agencies such as the Commission for Social Care Inspection to consider how the intersection between the single assessment process and the supporting people programme works.
	One cause of dispute in the Chamber and in Committee, relating to whether this Bill can be implemented effectively, can be examined. It is the shortage of specialist staff. The NAO report found that two groups in particularsocial workers and therapistsare in short supply. It was not only social services departments that foresaw a problem; it was the overwhelming view of primary care trusts that such shortages would continue to hamper dealing with issues of delayed discharge.
	I have one final question for the Minister, and I feel that this amendment could allow this issue to be monitored. It concerns the dividing line between what is NHS-funded continuing long-term care and what are NHS part-funded registered nursing care contributionsalso called free nursing care. I have raised a concern with the Minister and others on a number of occasions. The criteria for the highest band of registered nurse contributions are setting a threshold that requires a higher and more complex level of need than the eligibility criteria for fully funded NHS continuing care. It would be useful for that to be looked at.
	The nursing care practice guide and workbook states:
	People with high needs for registered nursing care will have complex needs that require frequent medical, technical and/or therapeutic intervention. They will need frequent intervention and re-assessment by a registered nurse throughout a 24 hour period and their physical/mental health state will be unpredictable.
	That is the definition used to enable a nurse to determine whether someone is in the top band and will receive a contribution of 110 towards their nursing care in a nursing home.
	The case studies in the workbook are examples that help nurses to apply the guidance meaningfully. However, it is interesting to compare them with the health ombudsman's report, which deals with real cases. The workbook stated that a woman who had suffered a cerebrovascular accidentCVAwould be placed in the highest band of nursing because she had suffered
	loss of speech and was unable to swallow; partial paralysis and poor balance and co-ordination, doubly incontinent, pressure sore and tearful and distressed. She requires peg feeding and enemas to maintain bowel function, the use of a hoist to ensure safe transfer, and monitoring of the pressure sore, teaching to improve sitting balance, review of need for anti-depressant therapy and work to maintain social interaction.
	The amendment should include provision for the inspectorate to examine such cases because the health service ombudsman found that peg feeding was a criterion for continuing NHS care in one authority but not in another. In one case, the ombudsman's report helpfully listed Mrs. N's needs. They were
	a hoist to help with transfers, a . . . catheter in place to deal with her incontinence of urine and assistance with her bowel function every three to four days; changing position to maintain skin viability, help with washing and oral care, and peg feeding. She did not appear to be depressed but smiled in response to other people.
	Those cases are similar, yet in one, used as an example, the person was entitled only to a contribution of 110 towards their nursing while in the othera real case cited in the health service ombudsman's reportthe person was entitled to have all their care met and paid for by the national health service. The Department's case study guidance is issued to nurses whose job is to make those systems work and it ought to lead to the conclusion that people are entitled to continuing NHS care funding.
	Will the Minister comment on that? More important, I hope that we do not have to rely only on the health service ombudsman to resolve, on a case-by-case basis, the problem of the dividing line between free continuing NHS care and nursing contributions. The Government should take the opportunity provided by the health service ombudsman's report to clarify the situation so that we stop the injustice that is undoubtedly being done to thousands of people who are being denied their rights.

Nigel Waterson: I am extremely puzzled by the attitude of the Minister and the Government to these perfectly sensible and appropriate amendments. Lords amendment No. 24 would specify bodies that will monitor the impact of the measure at regular intervals and Lords amendment No. 25 provides for an annual report to Parliament. As my right hon. Friend the Member for East Yorkshire (Mr. Knight) pointed out, such a report might give the Government the chance to trumpet the success of the legislation. I seem to recall that the Government used to issue an annual report to trumpet their achievements, but that practice seemed to fall into disuse two or three years agopresumably because there was not much to trumpet.
	I urge the Minister to think again about the amendment. I appreciate why she might be feeling defensive about the measure; as we have already established, the Bill does not have a friend in the world. Even some of the Government's Back Benchers, including the Chairman of the Select Committee on Health, are not willing to support it. It has caused a storm of protest throughout the country, expressed through the Local Government Association, the Association of Directors of Social Services and so on.
	The Minister seems to think that the amendment will wreak a huge sea change in the position. Indeed, her thesis, which seems to go further away from reality, is that the mere threat of the Bill has enormously improved the bed-blocking position and that it will make a vast difference and improve the lives of many hundreds of thousands of patients throughout the country. She may be right. If she is, fine, but I do not think that she is. Equally, the Opposition and various bodies may well be right, and the law of unintended consequences will kick in and set at odds with one another some of the agencies that, certainly in my constituency, are now working in much closer partnership than they ever did before.
	I pay tribute to East Sussex county council for its work in the past year or two, since it has been run by the Conservatives, who have got to grips with the issue and worked closely with the health organisations. Although there are occasional blips, the result is a steady decline in the number of beds blocked or delayed discharges.
	I concede that the truth may turn out to be somewhere between those two views. However, on any assessment, this is a brand new regime with some pretty draconian powers, and it could all go horribly wrong or, at the very least, not produce the results that the Minister wants, so I fail to understand why she does not think that monitoring its progress is a good idea. There may be some scope for discussing whether that duty should arise only in the initial stages of its implementation. I can understand the Minister's argument that that should not happen every year, for ever, if the legislation has settled down or, even more likely, the problem has gone away of its own accord.
	In the debate in the other place, Baroness Noakes said that, under the current arrangements, the bodies involved would be the Audit Commission, the Commission for Health Improvement and the social services inspectorate, and she put it extremely well. Of course we have heard that, yet again, some of those bodies are in a state of flux, and we will end up with something called the Commission for Health Care Audit and Inspection. Whatever label is attached to those bodies, if legitimate concerns are felt not just by the official Opposition or the Liberal Democrats, but by lots of people at the coalface throughout the country who deal with such problems daily, it is surely important that we should get an idea early on whether the provisions are having the effect that the Minister thinks that they should. Surely, she, more than anyone else, would wish to know whether that was the case.
	If I may give the Minister a bit of friendly advice, I do not think that she should associate herself too closely with the Bill or she may turn into another Minister who never was, like Lord Hunt who used to deal with such matters in the other place.
	The Bill's effects will need careful examination in the real world. We have heard about some of the problems. Baroness Noakes referred to some of them in the other place, and my hon. Friend the Member for West Chelmsford (Mr. Burns) has dealt with the problem of readmission, so I need not do so. It is possible that people will be discharged home without adequate support services, and there is a whole series of possible knock-on effects, simply because of this ill-thought-out, hurried Bill.
	It is worth quoting what the Right Rev. Bishop of Hereford said in the other place. He referred to what he called
	the widespread feeling that patients are treated . . . as commodities.[Official Report, House of Lords, 17 February 2003; Vol. 644, c. 975.]
	Other hon. Members and I have expressed that view in earlier debates on the Bill. That is the nub of the problem. The Opposition and many other people are worried that patients and their needs are not central to the Bill and that they will be pushed aside in the interests of what I have already called this bizarre game of pass the parcel. Let us stop using the words fines and incentives. I shall say that the Bill has financial repercussionsthat may make the Minister happyif people are holding the parcel when the music stops.
	There will be some serious, hard cases in the real world, affecting our constituents, as well as those of the Minister and other hon. Members, so why on earth does not the Minister want to reassure people? Of course she takes the view that the rest of the world is out of step and that she is the only one in step, but if she is so utterly convinced of her rectitude, why not put it to the test? As my right hon. Friend the Member for East Yorkshire has already said, if there is good news to tell, let her blazon it in the House with an annual report and let it be reported on and authenticated by those audit bodies.
	I could not agree more with the comment that Baroness Noakes made in last month's debate:
	the Bill . . . tends to marginalise the individuals who are at the heart of the processes.[Official Report, House of Lords, 18 February 2003; Vol. 644, c. 1029.]
	That has been and will continue to be our fear about the Bill. We are happy and willing to be proved wrong. Surely, the way to ensure that that happens is to use one or more of the sort of bodies that are so beloved of the Government to audit progress, see whether the legislation is working and report annually to Parliament. I cannot see the Minister's problem, as by accepting the amendmentsif she will only leave them alone, they are already part of the Billshe can at a stroke prove us all wrong and prove that hers is the lonely voice that has been right all along.
	I hope that the House will support the Lords in their amendments and maintain them in the Bill.

Greg Knight: We have just heard three very powerful speeches explaining why the Minister is wrong on the issue with which the amendments deal but not one voice raised in support from the Labour Benches.
	The Minister's opening remarks sounded rather half-hearted and certainly showed a paucity of reason. We are disappointed by her attitude to the amendments because we had a debate yesterday in which the Opposition were prepared to take a non-partisan approach on a very important issue and say that, where we thought that the Government and the Prime Minister in particular were right, they had our support. All that we are asking her to do is listen to our arguments and reflect on what she will say in advising the House about how to treat the proposed additions to the Bill. What are we seeking to do? We are seeking to say that proposals that are moderate, modest and reasonable should remain in the Bill.
	Amendment No. 24 states:
	The Secretary of State shall specify to the bodies charged with inspection of health and social services that they should monitor.
	The word monitor was put into the Bill by the other place, and it does not carry with it any of the implications to which the Minister referred in relation to a presumption of wrongdoing. The monitoring process would occur at regular intervals. If the Minister were willing to reflect on the matter again, I would be happy to accept that regular intervals do not need to involve continual monitoring, but could entail annual monitoring or even a biannual process. Surely, however, it is right to see that best practice is being followed and that it is consistent throughout the United Kingdom.
	I cannot understand why the Minister is not willing to accept Lords amendment No. 25. As you will be well aware, Mr. Deputy Speaker, it used to be said in the days of the previous Conservative Government that there was terrible pressure on parliamentary time and that it was not possible always to accommodate debates on every single issue that hon. Members felt was important. However, there has been a change in our procedures since that timethe addition of Westminster Hall. Although the former Leader of the House, who has just resigned his position, and his predecessor both gave an undertaking to the official Opposition that Westminster Hall would not be used for introducing legislation, there is consensus in all parts of the House that it could and should be used for debates on annual reports such as the one in question. In the light of the fact that we now have that other Chamber a stone's throw away from this place, I am at a loss to understand why the Minister will not accept the amendment.

Simon Burns: My right hon. Friend touches on an extremely important point. He is as aware as I am that Westminster Hall is already used to debate Select Committee reports, so the precedent exists and the powerful suggestion that he is making would dovetail with what already happens in our proceedings. 6.30 pm

Greg Knight: I agree wholeheartedly with my hon. Friend. An annual report does not have to be debated every year. If an annual report was good but was deemed to contain nothing exciting or worthy of criticism, then the usual channels could produce a system in which a debate did not have to occur every year. Clearly, cost is not an issue because the Minister did not mention it. I was apprehensive that she might argue that she did not want the amendments because of the cost to the Exchequer, but that does not seem to be a problem. I hope that she will think again. I say to her: be bold, be reckless and, in the light of the powerful arguments adduced in the debate, allow the amendments to stand.

Jacqui Smith: With the leave of the House, I shall respond to the debate.
	Hon. Members suggested that a monitoring and reporting system is not in place to ensure that the good outcomes produced by the Bill will be clearly monitored. However, I outlined a variety of waysI do not intend to repeat themin which that will be ensured. I think that the amendments are otiose and that it can be argued that they will have a detrimental effect on the inspection bodies that will be established.
	Having feigned indignation when I suggested that the amendments were proposed on the assumption that the health and social care services might not operate in the best interests of patients, the hon. Member for West Chelmsford (Mr. Burns) then gave a string of ways in which the system might indeed not operate in the best interests of patients. I reassure him that monitoring is in place to ensure that that does not happen. The NHS and social care performance indicators, introduced by the Government to ensure greater accountability of the performance of the NHS and social care services, already include delayed discharges, emergency readmissions and home care to help people live at home. We are also introducing indicators on the speed of service provision. Those will show when substantial problems arise.
	Hon. Members also asked about debating annual reports that are made to Parliament. Under the previous systemwith the exception of the Commission for Health Improvement, largely inherited from the Conservative Governmentannual reports were published, but not to Parliament. Under the new system, the Commission for Social Care Inspection and the Commission for Health Care Audit and Inspection will make annual reports to Parliament. We amply cover the concerns of hon. Members that both the successes and the challenges are reported to Parliament on an annual basis.
	When we debate the legislation to establish the new inspection bodies, I shall be interested to hear whether Opposition Members raise concerns about the need to ensure that they are able to make an independent determination of quality in the health service and social care service. That would be different from the approach taken by the hon. Member for West Chelmsford, who believes that we should instruct the bodies in the minutiae of their considerations.

Simon Burns: I did not say that.

Jacqui Smith: That is the implication of the Lords amendment. The other place claims to believe in the independence of the inspection bodies, but that claim lies rather uncomfortably with the proposals in the amendment.
	I want to spend some time responding to the points raised by the hon. Member for Sutton and Cheam (Mr. Burstow) about, among other things, his specialist subject of continuing care. On the points made by the National Audit Office about the definition of good practice, one of the important features of the Bill is that it will put in place a clear process and decision points for determining a delayed discharge and, therefore, the point at which reimbursement should kick in. I heard what the hon. Gentleman said about his colleagues on the metropolitan authority in the west midlands, but perhaps that authority would welcome a visit from the Department's implementation team to ensure that some of the concerns can be ironed out before the Bill comes into force.
	The hon. Gentleman asked about the broader definition of delayed discharge. Sir Nigel Crisp, the chief executive of the NHS, has written to those trusts that told the National Audit Office that they were not using the definition. All of them have confirmed that they are now using the correct definition.
	The hon. Gentleman also asked about continuing care and its relationship with free nursing care. When nurses undertake a determination of NHS-funded nursing care, we have made it clear that all nurses should consider eligibility under continuing NHS health care criteria as the first step in assessing people's needs for care in a care home providing nursing. Furthermore, in the guidance on NHS-funded nursing care, we have consistently maintained the distinction between NHS-funded nursing care and continuing NHS health care, making it clear that NHS-funded nursing care is part of a spectrum of care that falls short of what one would expect to see when the primary need is for health care. As I have suggested, we have made it clear that, regardless of the eventual setting in which someone is likely to be cared for, we expect the first consideration in a joint assessment of someone's need to be always the extent to which that person meets or does not meet the criteria for NHS continuing health care.

Paul Burstow: The Minister is making some helpful clarifications. However, will she also undertake to take away the workbook that is currently used for guiding nurses in applying the tool for assessing the entitlement to free nursing care contributions? The workbook contains a case that is exactly the same as a real case considered by the ombudsman, and that must provide incorrect information and the incorrect basis for making decisions.

Jacqui Smith: I was just coming to that point. I have pointed out that the first task is to assess whether someone has a need for NHS continuing care and emphasised that we must consider that on a case-by-case basis. The fictitious case that the hon. Gentleman mentioned would be considered in the assessment of nursing care only if the continuing care criteria were not met. A consideration of that would previously have been carried out. The hon. Gentleman's points about the workbook are not justified.
	We are considering inspection and monitoring, and the hon. Gentleman asked whether we could consider the monitoring of the continuing care criteria. Although not solely in response to his concerns, we have asked CHI to consider local policies and criteria as part of a review of the older people's national service framework.
	In conclusion, I believe I have provided the reassurance that right hon. and hon. Members wanted. The amendments are unnecessary and challenge the current arrangements and the independence of the inspectorates that we want to develop. For that reason, I hope the House will disagree with the Lords.

Question put, That this House disagrees with the Lords in the said amendment:
	The House divided: Ayes 308, Noes 198.

Question accordingly agreed to.
	Lords amendment disagreed to.
	Lords amendment: No. 25
	Motion made, and Question put, That this House disagrees with the Lords in the said amendment.[Jacqui Smith.]
	The House divided: Ayes 318, Noes 198.

Question accordingly agreed to.
	Lords amendment disagreed to.
	It being after Seven o' clock, Mr. Speaker then proceeded to the Questions necessary to conclude proceedings, pursuant to Orders [28 June 2001 and 29 October 2002.]

After Clause 3

Lords amendment: No. 26.
	Motion made and Question put, That Government amendment (a) to the said amendment be made:
	The House divided: Ayes 315, Noes 197.

Question accordingly agreed to.
	Amendment (a) to Lords amendment No. 26 agreed to.

After Clause 4

Lords amendment: No. 35
	Motion made, and Question put, That amendment (a) to the said amendment be made.[Jacqui Smith.]
	The House divided: Ayes 314, Noes 193.

Question accordingly agreed to.
	Amendment (a) to Lords amendment No. 35 agreed to.
	Remaining Lords amendments agreed to.
	Committee appointed to draw up Reasons to be assigned to the Lords for disagreeing to certain of their amendments to the Bill; Mr. Simon Burns, Mr. Paul Burstow, Jim Fitzpatrick, Mr. Andrew Love and Jacqui Smith; Jacqui Smith to be the Chairman of the Committee; Three to be the quorum of the Committee.[Mr. Woolas.]
	To withdraw immediately.
	Reasons for disagreeing to certain Lords amendments reported, and agreed to; to be communicated to the Lords.

DELEGATED LEGISLATION

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

International Development

That the draft African Development Fund (Ninth Replenishment) Order 2003, which was laid before this House on 24th February, be approved.[Mr. Woolas.]
	Question agreed to.

Mr. Speaker: With the leave of the House, I shall put together the Questions on motions 5, 6, 7, 8 and 9.
	Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

International Development

That the draft International Fund for Agricultural Development (Fifth Replenishment) Order 2003, which was laid before this House on 24th February, be approved.

Agriculture (Miscellaneous Provisions)

That the draft Code of Recommendations for the Welfare of Livestock: Cattle, which was laid before this House on 26th February, be approved.

Local Government

That the draft Local Authorities (Charges for Specified Welfare Services) (England) Regulations 2003, which were laid before this House on 4th March, be approved.

Terms and Conditions of Employment

That the draft Paternity and Adoption Leave (Adoption from Overseas) Regulations 2003, which were laid before this House on 24th February, be approved.

Terms and Conditions of Employment

That the draft Employment Rights Act 1996 (Application of Section 80B to Adoptions from Overseas) Regulations 2003, which were laid before this House on 24th February, be approved.[Mr. Woolas.]
	Question agreed to.
	Motion made, and Question put forthwith, pursuant to Standing Order No. 18(1)(a)(Consideration of draft regulatory reform orders),

Housing

That the draft Regulatory Reform (Housing Management Agreements) Order 2003, which was laid before this House on 24th February, be approved.[Mr. Woolas.]
	Question agreed to.

PANXHI FAMILY

Motion made, and Question proposed, That this House do now adjourn.[Mr. Woolas.]

Ann McKechin: I am grateful for the opportunity to raise in the House this evening the case of the Panxhi family and their application for asylum in this country. As you are aware, Mr. Speaker, the family currently reside in your constituency of Springburn; I know that you are very familiar with the circumstances of their case and have taken a close interest.
	The family consist of Mrs. Valentina Panxhi and her childrenBrikena, aged 12, Enea, aged 9 and Grace, who was born in 2001 when the family had arrived in Scotland. Mrs. Panxhi's husband, Edmond, was a prominent member of the minority Albanian Monarchist party and had suffered a period of harassment, including a number of violent beatings and death threats. In January 2000, their daughter Brikena was harassed at school by the secret services. On another occasion, Mrs. Panxhi was stopped in the street by some men and threatened. As the threats intensified, the family went into hiding. Mr. Panxhi was arrested in September that year, but after his release the family decided that their safety was not secure in their home country and they made plans to escape. Mrs. Panxhi, then pregnant with Grace, together with the two older children, left Albania in November, with the intention that her husband would join them at a later date when he was able to get enough money. There is no doubt in the Panxhi family's mind, and in the minds of all the many people who have taken an interest in their case, that they were in genuine fear of persecution and the threat of violence if they remained in Albania at that time.
	Sadly, a short time after Mrs. Panxhi and her children had arrived in the United Kingdom, they were advised that Edmond Panxhi had been killed. It is difficult to imagine how the family must have felt: strangers in an unfamiliar country, their initial application for asylum refused, terrified of returning to their home and grief-stricken at the sudden, violent death of a beloved husband and father. However, it was their resilience and courage in facing up to that tragic news that so impressed the many, many people in Scotland who support their request to remain in this country. I very much hope that, even at this late stage, the Minister for Citizenship and Immigration, my hon. Friend the hon. Member for Stretford and Urmston (Beverley Hughes), will agree to reconsider her Department's earlier decision.
	Such was the tremendous response to the family's plight that a small number of local Glasgow people went to Albania on a fact-finding mission in June last year. They were led by the Rev. Bryan Owen, a Church of Scotland minister who has just retired after more than 30 years as minister of St. Rollox church. As you know, Mr. Speaker, he is a well-respected figure in the local Springburn community.
	The group interviewed a large number of people in Elbasan and Tiranc and received a great deal of corroboration of Mrs. Panxhi's story of the problems faced by the family before their escape to the UK. However, as I hope that my hon. Friend the Minister will appreciate, it is difficult to discover hard evidence that can be put to a UK tribunal or court system. Although members of the fact-finding group could not prove that Edmond Panxhi was killed for political reasons, they were convinced that he was dead.
	All the people who knew Edmond Panxhi told the group that he was a somewhat secretive person who did not tell others about his business, but that he was loving and caring to his family and could not have remained out of touch with them if he was alive. Members of the group were also told by all their Albanian contacts, including the Elbasan police, that he had absolutely no contact with crime and thus no reason to fake his own death.
	Rev. Owen and and his colleagues spoke to a number of local people in the small village at Gjinar where the family had hidden in 2000. They confirmed that the Panxhi family had stayed with them and that during that time Mrs. Panxhi had been terrified of suffering further violence. In particular, she had been afraid of Colonel Koseni, the now discredited chief of police in Elbasan. I hope that the Minister will accept that the family's motives for leaving Albania were genuine and not economically motivated.
	The Minister will be aware that, although there have been improvements in Albania, widespread corruption and violence are still common. Mrs. Panxhi fears greatly for the safety of her son, Enea. Albania is still blighted by a blood feud culture; when a son comes of age he is expected to avenge the death of his father. Commenting on the case, Jim Wallace MSP, Minister for Justice in the Scottish Executive, said that there was
	a very real danger that Enea will himself be murdered by his father's murderers before he comes of age, to pre-empt any revenge he may seek.
	As I have already mentioned, despite the many harsh problems faced by the family over the last few years, their courage and dignity have impressed many. There has been widespread media interest in Brikena's musical talents. When she arrived in this country she spoke no English but she is now bilingual and has an exemplary record at her local school, St. Roch's secondary. She also studies violin at the junior academy of the Royal Scottish Academy of Music and Drama, where she was awarded a Wolfson scholarship last year. She was also among the three finalists for The Scotsman young achiever of the year award in November 2001, as the hon. Member for Banff and Buchan (Mr. Salmond) will be aware, since I understand that he was one of the judges.
	Brikena's violin teacher, Mr. Hugh MacGilp, who has taught young musicians for more than 40 years, has written personally to the Home Office on her behalf. He strongly believes that she has the potential to be a professional musician provided that she receives the level of support from which she currently benefits. Specifically, he pointed to considerable gaps in her knowledge when she arrived from Albania. The head of the junior academy has also written to the Home Office to confirm that despite the enormous pressures and uncertainties that she faces, she is making excellent progress and is developing a musical ability that will enable her to make a positive and constructive contribution to society in her later life.
	If the family were to return to Albania they would meet extreme hardship. They could not expect accommodation or financial help from Mrs. Panxhi's family, as they are already living under straitened circumstances. Mrs. Panxhi would have difficulty in finding work while looking after a young baby and, in all likelihood, Brikena would have to leave school at the earliest opportunity to earn money, and her musical education would not continue.
	A musical talent such as Brikena's is a rare gift. I played a musical instrumentnot terribly wellat school but I watched one of my school colleagues develop her skills at the Royal Scottish Academy and go on to become a professional musician. Playing music well is a genuine joy, but that talent, especially for those who want to be classical players, needs a huge amount of work and practice from an early age.
	The UN convention on the rights of the child speaks about the need to
	ensure that children will be able to develop talents and abilities to their fullest potential.
	Of course, many children in today's world unfortunately never get the opportunity to develop their true talents, but to have been given that opportunity and then have it taken away is just as cruel.
	Mrs. Panxhi and her family have made a real and positive contribution to the local community in Springburn and, if they had an opportunity to stay, would seek to be economically independent at the earliest opportunity. They have suffered great trauma in the past few years and wish only to live peacefully and quietly in our city. In Springburn, they have experienced some feeling of security, but they genuinely remain very afraid for their safety and future if they must return to Albania at this time.
	I thank the Minister for taking further time to consider this case, and I ask her to consider the very strong compassionate reasons for allowing the family to remain in the United Kingdom. The people of Springburn and Glasgow have welcomed them and ask the Minister now to allow them to stay with us.

Alex Salmond: It is a very great pleasure to follow the hon. Member for Glasgow, Maryhill (Ann McKechin) in this debate, and I endorse everything that she has said about the case history of the Panxhi family. She was right to say that I had the pleasure of meeting them for the first time slightly more than 14 months ago, at The Scotsman young achiever of the year award in November 2001, when Brikena was one of the finalists. I therefore took an interest in their case. The hon. Lady has spelled out extremely well the circumstances that the family face.
	I want to try to underline in some very brief remarks the compassionate grounds for ministerial intervention. Although I certainly agree with the hon. Lady that Valentina Panxhi has shown exemplary courage and fortitude, given the circumstances in which she has found herself, I want to speak about the three children in the case, because therein lies the strongest argument for intervening on compassionate grounds.
	First, Grace will be two years old this June. She was born, obviously posthumously, in Scotland. I know full well that being born in a country does not confer a legal right of citizenship, but I make the case that that young lady has no other circumstances or home but Springburn in Glasgow and, morally, she is as much a Glaswegian as you are, Mr. Speaker, and as much a Scot as I am. That is a consideration, because the world has moved on and that young child has been born in Glasgow, where she is being nourished and is growing up.
	Secondly, Enea, who is nine years old, was mentioned by the hon. Lady, and I want to draw attention to the point that she made because it is fundamental. There is a good deal of evidence to suggestit cannot be proventhat Mr. Panxhi was murdered for political reasons. Even if he was murdered for another reason, the Home Office case has rested on the argument at various times that, because Mr. Panxhi is dead, the rest of the family are no longer in danger. That is fundamentally mistaken, and I shall repeat the quote that the hon. Lady read out. No less a person than the Scottish Justice Minister, Mr. Jim Wallace, said that there is
	a very real danger that Enea will himself be murdered by his father's murderers before he comes of age, to pre-empt any revenge he might seek.
	That culture of the blood feud is a very important consideration in this case, and I shall illustrate that by quoting a brief extract from an Albanian news service. It is dated 2 April 2002 and reads:
	Murder in Bajram: on Tuesday April 2nd the sister of the four Haklaj brothers, who have been murdered in blood feuds, killed two and wounded two others. One of the wounded was a passer-by . . . a teacher . . . has stated that she will not marry nor will she die until she has taken revenge on the deaths of her brothers. This killing occurred at 12.00 midday in the middle of Bajram.
	That illustration of the culture of blood feud must surely be a consideration in intervening on compassionate grounds. It is not the case, just because the father is dead, that the rest of the family are not in danger if they return to Albania.
	Thirdly and finally, Brikena has been awarded a Wolfson scholarship to attend the Royal Scottish Academy of Music and Drama. Such scholarships are not easily won or awarded. Obviously, I was hugely impressed not only by Brikena's talent, but by her having overcome considerable difficulties to gain that scholarship and reach the final of the young achiever of the year award. I cannot believe that Scotland is so overflowing with young talent that we can afford lightly to send back to Albania a young woman of such potential.
	The underlying point that arises in respect of all three children and shines out in the family's story is the amount of support and succour that they have been given by the local community in Sighthill and Springburn. The hon. Lady mentioned the church connections. I have had the pleasure of visiting St. Rollox church and meeting the various people who have surrounded the family and given them such support.
	It is not that long since we all thoughtI know that you, Mr. Speaker, were deeply concerned about this matterthat we faced in Sighthill a particular problem that has been seen in many areas with regard to the influx of asylum seekers. That situation has largely been turned around in the past year by the strength, support and infrastructure of the local community. Indeed, only a few weeks ago, BBC Scotland broadcast a programme called Rabbie's Bairns that focused on the Springburn area of Glasgow. One of the children who achieved a high accolade in that programme was a young asylum seeker. The programme was so inspirational in showing the integration into local schools and the local community of asylum seeker children that it managed to win an award in celebration of the works of Scotland's greatest poet.
	That is an illustration of how the community is supporting this and other families. I ask the Minister to consider whether the achievements of Springburn, which have been supported by so many good-minded and good-willed people, would be put at risk if we were to return this family to Albania, when there are so many arguments to suggest that an intervention on compassionate grounds would be not only appropriate, but undoubtedly the right thing to do.

Beverley Hughes: I am very grateful to my hon. Friend the Member for Glasgow, Maryhill (Ann McKechin) and, indeed, to the hon. Member for Banff and Buchan (Mr. Salmond) for the opportunity to debate this case, which is a very difficult one. Sadly, it is not by any means the only difficult case to have come across my desk. I know that it has gathered considerable support from the local community in Glasgow.
	I shall begin by providing a brief background to the family's case. As my hon. Friend said, Mrs. Panxhi and her children arrived in the United Kingdom clandestinely on 9 November and made an asylum application the following day. As has been said, that claim was based on her husband's political activities. Mrs. Panxhi claimed that her husband was a candidate for the vice-presidency of his political party. She was interviewed a month later and a decision was taken to refuse her application on 15 December 2000. She appealed against that decision and gave oral evidence at her appeal in April 2001.
	An independent adjudicator carefully considered Mrs. Panxhi's asylum claim, but did not feel that there was any merit in it. The adjudicator rejected her claim that her husband was a candidate for the vice-presidency of the party, further noted that she and her children had never been harmed in Albania, and also considered the family's rights under the European convention on human rights. He concluded that there was no evidence to suggest that the Panxhi family could not lead a normal life on return to Albania, so he dismissed the appeal in May 2001. Mrs. Panxhi appealed to the immigration appeal tribunal, which upheld the adjudicator's decision in October 2001. She then applied for leave to appeal to the Court of Session, but that request was dismissed in January last year.
	Mrs. Panxhi has had several opportunities to state her case to be allowed to remain in the United Kingdom. She applied for asylum in November 2000 and completed the appeals process in January 2002. During that 15-month period, she has been interviewed and has had two substantive appeals, which were both conducted by independent judicial adjudicators. She gave oral evidence and was given the opportunity to raise additional reasons why she should be allowed to remain in the UK. In fact, Mrs. Panxhi's case was dealt with under the one-stop appeals process, which required her to outline all the reasons why she should be allowed to remain. Furthermore, during the course of that process, and following representations by the Speaker and the hon. Member for Banff and Buchan, Mrs. Panxhi was invited to provide evidence that her husband was, as she claims, dead, but no evidence has been forthcoming.
	I do not believe that Mrs. Panxhi or her children would suffer any ill-treatment should they be returned to Albania and I want to outline why I have come to that conclusion. The immigration appeal tribunal concluded that there appears to be
	negligible, or minimal, risk of ill-treatment of the appellant or family, either at the hands of the authorities in Albania, or at the hands of parties against whom the Albanian authorities would be unwilling or unable to provide effective protection.
	Hon. Members know that the Government believe that Albania is safe. The objective country assessments indicate that the Albanian Government respect the rights of their citizens, and our statistics on asylum claims confirm that. In the past two years, 139 families have been returned to Tirana, and Albania has taken the first steps towards EU accession.
	In terms of quality of life, I understand that the Albanian authorities provide at least eight years' free education. The main focus of support within Glasgow has been on Brikena's considerable talents as a violinist. I am aware that she has been awarded a music scholarship. However, I am told that opportunities exist within Albania for Brikena to develop her musical talents and that she gave up a place at a specialist music school before coming to the UK.
	In summary, it is clear that the Panxhi's case has been carefully considered and that the decisions are right.

Alex Salmond: Will the Minister concede that it might be difficult for Mrs. Panxhi to establish that her husband has been murdered? The murderers would be unlikely to advertise themselves to people who make inquiries. Does she accept the concerns outlined by the Scottish Justice Minister that if Mr. Panxhi has been murdered, his son might be at risk in Albania? Does she accept that there is a culture of blood feud in that country?

Beverley Hughes: If it is accepted that Mr. Panxhi was murdered, our approach would depend on whether that was as a result of persecution or a criminal matter that the authorities in Albania would be expected to respond to appropriately. Someone being murdered does not of itself engage the terms of the European convention on human rights. Whether a death constitutes persecution under the convention depends on the circumstances and the reasons why someone has been killed.

Alex Salmond: Regardless of the circumstances of the murder, a blood feud is a blood feud. The example that I gave from an Albanian news agency was not of a political murder, but of a murder that was the result of a blood feud that had developed. The Minister is right about the convention, but the safety of the child returning to Albania would still be in question if it could be established that Mr. Panxhi was murdered. Does the Minister accept that that could be a danger?

Beverley Hughes: I have two points to make on that. It would depend on the ability of the authorities, and the judged ability of the authorities, to provide adequate protection and a proper system of criminal justice to deal with a risk that engages if not the convention, but a human rights issue in terms of a need for protection.
	As I said earlier, I understand that the hon. Gentleman and my hon. Friend the Member for Glasgow, Maryhill are conveying the probably very sincerely held views of the family. However, the case has been examined thoroughly by a judicial adjudicator in an independent appellate hearing. The leave to appeal has also been examined by another tier of authority at the tribunal. I simply say to the hon. Gentleman that it is not for me or for him to judge the facts of the case. It has been through a proper process, and I have described the judgment that emerged.
	I now turn to a point that is important in how we deal with such cases. On top of the process that I have described, there has been ministerial involvement since July 2001, when Mr. Speaker wrote to my predecessor and the hon. Member for Banff and Buchan took up the case. The ministerial involvement continued when I took up my post and I met Mr. Speaker in January this year. At that meeting, I undertook to review the case again, and I did that. I went through it chapter and verse. I considered it very carefully, and that took me a long time. I went through all the evidence and all the determinations and gave it very careful scrutiny before deciding, at that time, to uphold the decision. I wrote to Mr. Speaker outlining why.
	I understand absolutely the compassion and the good intentions that are motivating Members of Parliament and the local community, because I have been in the same position with similar cases with families in my constituency. I have seen many similar families in many similar circumstances who report similar experiences. The problem for me is that, although I can and do exercise discretionthat is allowed within the lawI have to do so on the basis of very exceptional circumstances. Such circumstances involve cases that have been through a proper judicial process in which a person is able to cross-examine, hear the cross-examinations of both sidesneither the hon. Gentleman nor I are able to do thatand come to a decision.

Alex Salmond: The Minister will accept that any process is limited by the time available to interview and cross-examine. For example, the appeal tribunal of 19 September noted in its evidence:
	For all that was known
	about Mr Panxhi
	he might have died, for example, in a road accident.
	That strikes me as a particularly crass way to comment on a case involving such emotions.
	Any tribunal can interview people only over a period of time. The local community in Sighthill has known the family for a number of years. Does the Minister really think that, unless the family had impressed the community with the total veracity of their case, the community would campaign so hard and show such absolute determination in this case? Does that not weigh in her judgment if there is a balance of doubt?
	With due respect to the Albanian schooling system, Brikena's scholarship to the Royal Scottish Academy of Music and Drama is exceptional. It is an indication of the exceptional talent that the academy wishes to keep in Scotland. Does that weigh with the Minister in terms of compassionate grounds even for the length of the child's schooling and exercise of the scholarship?

Beverley Hughes: On the hon. Gentleman's first point, I do not think that the extent to which a community takes to its heart a particular family can be a substitute for a proper judicial examination of the claimed facts of the case. The fact that a community does that is understandable. It means that they are a good family, that they are worthy people, that the children are talented and that the family have made connections and relationships in the community. Those are all very good things in their own terms. But that does not differentiate the family from many others, and it does not substitute for a fair and transparent process.
	We must have a system that is open and fair, with decisions based on rational, defendable principles, so that people in similar circumstances can expect that they will be treated similarly. It would not be right, would it, to allow to stay those people who happened to have gained the support, for all the right reasons perhaps, of their MPs and local people, but to continue to return those who do not get such support or who do not have a campaign developed for them in the community?
	As I said, there is discretion, and I exercise discretion, but very rarely. It must be on the basis of truly exceptional circumstances. When people have been through a judicial process, there must be exceptional circumstances to justify my intervention. The circumstances of this case, as worthy, as delightful and as talented as the family areI have read all the press reports and seen the pictures; I am not trying to make the decision easy for myself by not getting to know something about the familyare similar to those of many other families who have already been returned to their home country or who will be returned in the future.
	In conclusion, I have come, more or less, to a final decision. So that it is clear that I have completely exhausted the process, there is one particular piece of evidence that I will ask to see before finally making that decisionthat is, the second piece of evidence to which the hon. Member for Banff and Buchan referred concerning the commentary on blood feud and the potential risk to the son. I will look at that further evidence. I do not want to raise hopes, but I want to be able to say that I have taken every opportunity to consider anything that might be relevant.
	Question put and agreed to.
	Adjourned accordingly at one minute past Eight o'clock.